Individual provider Active NPI

Jasmin Hernandez, CADC I

  • Addiction (Substance Use Disorder) Counselor
  • Banning, CA
National Provider Identifier
1043039910
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CI44340924 Issued in CA
Practice address
11555 1/2 Potrero Rd
Banning, CA 92220-6946
Phone
(951) 849-4761
NPI assigned
Oct 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X CI44340924 CA Primary

Addresses

Primary practice location

11555 1/2 Potrero Rd
Banning, CA 92220-6946

Mailing address

15565 Via Montana
Desert Hot Springs, CA 92240-6925
Phone (760) 975-6511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CI44340924CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1043039910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15565 VIA MONTANA",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922406925",
            "telephone_number": "760-975-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 1/2 POTRERO RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206946",
            "telephone_number": "951-849-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JASMIN",
        "credential": "CADC I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI44340924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.