Individual ProviderDerek Anthony HernandezAdult CompanionNursing Service Related ProvidersPractice Address121 Downey Ave, Modesto, CA 95354-1208(209) 341-1824PECOS EnrollmentBased on the most recent information from CMS, provider Derek Anthony Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1659190395Provider TypeIndividualFull NameHernandez, Derek AnthonyGenderMaleSole ProprietorNoEnumeration Date10/9/2024Last Updated5/15/2025Contact InformationPractice LocationPractice Address121 Downey Ave, Modesto, CA 95354-1208Phone(209) 341-1824FaxUnlisted FaxMailing LocationMailing Address121 Downey Ave, Modesto, CA 95354-1208Phone(209) 341-1824FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode372600000XPrimaryDescriptionAdult CompanionNursing Service Related ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer