Provider Demographics
NPI:1124817101
Name:HERNANDEZ, NATALIE (RT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4186 JONES AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2903
Mailing Address - Country:US
Mailing Address - Phone:951-275-4725
Mailing Address - Fax:
Practice Address - Street 1:3950 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3517
Practice Address - Country:US
Practice Address - Phone:951-358-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist