Individual
ELISHA JANELL HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
855 3RD AVE STE 1110, CHULA VISTA, CA 91911-1350
(619) 934-5770
Mailing address
855 3RD AVE STE 1110, CHULA VISTA, CA 91911-1350
(619) 601-1393
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
163W00000X
Registered Nurse
Primary
613945
CA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
613945
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
613945
—
CA
Enumeration date
02/28/2019
Last updated
05/10/2023
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