Individual provider Active NPI

John Devon Herrera

  • Chiropractor
  • Fullerton, CA
National Provider Identifier
1033812433
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
35173 Issued in CA
Practice address
1841 W Commonwealth Ave
Fullerton, CA 92833-3013
Phone
(951) 961-6410
NPI assigned
Mar 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 35173 CA Primary

Addresses

Primary practice location

1841 W Commonwealth Ave
Fullerton, CA 92833-3013

Mailing address

1841 W Commonwealth Ave
Fullerton, CA 92833-3013
Phone (951) 961-6410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805000032 CA Practitioner - Chiropractic 1153839790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Center of Corona IncGroup PAC ID 4981904737, 10 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 203
Corona, CA 92882-2506
Phone (951) 737-1252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35173CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Center of Corona Inc. CurrentSince Jul 1, 2025 Accepting new patients
Herrera Chiropractic & Pain Management, Inc. Chiropractor CurrentSince Apr 6, 2023 Accepting new patients
Pirritano Chiropractic Corporation Chiropractor Past Accepting new patients

Locations

2250 S Main St
Ste 203
Corona, CA 92882
Phone (800) 595-2447

1841 W Commonwealth Ave
Fullerton, CA 92833
Phone (714) 676-5828

9496 Magnolia Ave
Ste 201
Riverside, CA 92503
Phone (951) 737-1252

370 W 6th St
Ste 100
San Bernardino, CA 92401
Phone (909) 381-3492

32475 Clinton Keith Rd
Ste 108
Wildomar, CA 92595
Phone (909) 609-0399

Organizations & group practices 3

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": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679702400000",
    "number": "1033812433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 W COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333013",
            "telephone_number": "951-961-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 W COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333013",
            "telephone_number": "951-961-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "JOHN DEVON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "35173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.