Provider Demographics
NPI:1699294801
Name:HERNANDEZ, JOSEPHINE VARGAS (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:VARGAS
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:MC FARLAND
Mailing Address - State:CA
Mailing Address - Zip Code:93250-1328
Mailing Address - Country:US
Mailing Address - Phone:661-900-1535
Mailing Address - Fax:
Practice Address - Street 1:5400 ALDRIN CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2103
Practice Address - Country:US
Practice Address - Phone:661-489-5999
Practice Address - Fax:661-489-5991
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95007269207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty