Active NPI
Jessica Hernandez, FNP-BC
- Family Nurse Practitioner
- Sylmar, CA
National Provider Identifier
1972227098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95021248
- Practice address
- 14445 Olive View Dr
Sylmar, CA 91342-1437 - Phone
- (747) 210-4186
- NPI assigned
- Oct 3, 2022
- Reactivated
- Oct 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95021248 | CA | Primary |
Addresses
Primary practice location
14445 Olive View Dr
Sylmar, CA 91342-1437
Mailing address
3113 W Chandler Blvd
Burbank, CA 91505-2646
Phone (818) 823-7587
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122000489 | CA | Order and Referring Only - Nurse Practitioner | 1658749775 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732752000000",
"number": "1972227098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3113 W CHANDLER BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052646",
"telephone_number": "818-823-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14445 OLIVE VIEW DR",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913421437",
"telephone_number": "747-210-4186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "JESSICA",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-03",
"last_updated": "2024-11-28",
"certification_date": "2024-11-28",
"deactivation_date": "2022-10-06",
"reactivation_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95021248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.