Nicole Hernandez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA58000 Issued in CA

Practice address

955 Carrillo Dr Ste 300
Los Angeles, CA 90048-5400

Phone

(424) 258-0124

NPI assigned

Sep 27, 2017

Reactivated

Sep 23, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physicians and Surgeons Home Care Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1184105231
  Medicare reassignment
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1902315427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 S FAIRFAX AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900194401",
            "telephone_number": "424-258-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485400",
            "telephone_number": "424-258-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "deactivation_date": "2020-05-11",
        "reactivation_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Hernandez
• Nancy Hernandez
• Nancy Karina Hernandez, LCSW
• Narciso Hernandez
• Natalia F Hernandez
• Nirel Idalid Hernandez
• Norma Hernandez
• Norma Angelica Hernandez, MSW INTERN
• Oscar Anthony Jr. Hernandez
• Paola Sebastiana Hernandez

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.

Verify at the official NPI Registry.