Individual provider Active NPI

Jessica Hernandez

  • Family Nurse Practitioner
  • Vista, CA
National Provider Identifier
1013668680
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023331 Issued in CA
Practice address
1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone
(760) 631-5000
Fax
(760) 414-3892
NPI assigned
Jan 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 257288 TN
Registered Nurse 163W00000X 95268580 CA
Family Nurse Practitioner 363LF0000X 95023331 CA Primary

Addresses

Primary practice location

1000 Vale Terrace Dr
Vista, CA 92084-5218

Mailing address

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone (760) 631-5000

Other practice location 1

50100 Golsh Rd
Valley Center, CA 92082-5338
Phone (760) 749-1410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230215002724 CA Practitioner - Nurse Practitioner 8022480250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian Health Council IncGroup PAC ID 5294644795, 21 clinicians

Practice addresses (Care Compare)

50100 Golsh Rd
Valley Center, CA 92082-5338
Phone (760) 749-1410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
257288TNMDRegistered Nurse
95023331CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Health Council, Inc CurrentSince Dec 16, 2022 Accepting new patients

Locations

50100 Golsh Rd
Valley Center, CA 92082
Phone (760) 749-1410

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jessica.hernandeznp.p1@direct.vistacommunityclinic.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1013668680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50100 Golsh Rd",
            "address_purpose": "LOCATION",
            "city": "Valley Center",
            "state": "CA",
            "postal_code": "920825338",
            "country_code": "US",
            "telephone_number": "760-749-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "257288",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95268580",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.