Provider Demographics
NPI:1285342642
Name:HERNANDEZ-CRUZ, ANA J (FNP-BC, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:J
Last Name:HERNANDEZ-CRUZ
Suffix:
Gender:F
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 W 188TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5832
Mailing Address - Country:US
Mailing Address - Phone:213-407-4540
Mailing Address - Fax:
Practice Address - Street 1:4455 W 117TH ST STE 200
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2240
Practice Address - Country:US
Practice Address - Phone:626-457-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF10221515363LF0000X
CA2022068231363LF0000X
CA95023357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily