Individual
GLORIA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
49869 CALHOUN ST STE 204&205, COACHELLA, CA 92236-9720
(760) 398-9090
(760) 391-5338
Mailing address
83427 PLUMA DORADA CT, COACHELLA, CA 92236-5487
(760) 625-6993
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A9234443
DL
CA
Enumeration date
09/27/2019
Last updated
04/01/2024
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