Provider Demographics
NPI:1164218053
Name:HERNANDEZ, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 N FISHER ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-5702
Mailing Address - Country:US
Mailing Address - Phone:559-558-2970
Mailing Address - Fax:
Practice Address - Street 1:1752 E BULLARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5864
Practice Address - Country:US
Practice Address - Phone:559-330-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician