Organization
J. HERNDONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSIE AURORA HERNDON (CO)
(760) 778-6120
Entity
Organization
Contact information
Practice address
69730 HIGHWAY 111 STE 109, RANCHO MIRAGE, CA 92270-2873
(760) 778-6120
Mailing address
69730 HIGHWAY 111 STE 109, RANCHO MIRAGE, CA 92270-2873
(760) 778-6120
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
330114AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330114AP
PRIVATE
—
Enumeration date
10/15/2013
Last updated
07/10/2024
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