Provider Demographics
NPI:1801770094
Name:HERNANDEZ, CHRISTIAN NOE
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:NOE
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18048 LONGHORN LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3938
Mailing Address - Country:US
Mailing Address - Phone:909-342-8784
Mailing Address - Fax:
Practice Address - Street 1:1307 W 6TH ST STE 119C
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-1642
Practice Address - Country:US
Practice Address - Phone:909-342-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56092225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist