Provider Demographics
NPI:1679319651
Name:HERNANDEZ, REBECCA MONICA
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MONICA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:MONICA
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 WILLIAMS DR STE 160
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:805-981-9240
Mailing Address - Fax:
Practice Address - Street 1:1911 WILLIAMS DR STE 160
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator