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Individual

EDWARD FIDEL HERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
2523 EL PORTAL DR, SUITE 103, SAN PABLO, CA 94806-3305
(510) 215-3730
(510) 215-3731
Mailing address
520 ADAMS ST, ALBANY, CA 94706-1106
(707) 536-3077
(707) 536-3077

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
387107
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
387107
REGISTERED NURSE LICENSE
CA
Enumeration date
12/13/2006
Last updated
09/04/2013
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