Provider Demographics
NPI:1194693135
Name:HERNANDEZ, ELESHA L (RN)
Entity type:Individual
Prefix:
First Name:ELESHA
Middle Name:L
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3216
Mailing Address - Country:US
Mailing Address - Phone:707-443-2248
Mailing Address - Fax:707-443-4847
Practice Address - Street 1:2321 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3216
Practice Address - Country:US
Practice Address - Phone:707-443-2248
Practice Address - Fax:707-443-4847
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95428483163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse