Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JESSICA HERNANDEZ
Active Sole ProprietorResidential Treatment, Emotionally Disturbed Children · CORVALLIS, OR
Registration Details
- NPI Number
- 1336004233
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 22, 2025 (0.33140945808834 yrs)
- Last Updated
- Dec 22, 2025
- Sole Proprietor
- Yes
Practice Information
- Address
-
4400 NW WALNUT BLVD APT 71CORVALLIS, OR, 973303298Browse OR providers · Browse ZIP 97330
- Phone
- 5417400708
- Primary Specialty
-
Residential Treatment, Emotionally Disturbed Children
322D00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.