Individual provider Active NPI

Jorge Reynaldo Hernandez, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1043581085
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1500 21St St
Sacramento, CA 95811-5216
Phone
(916) 914-6354
NPI assigned
Jan 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1500 21St St
Sacramento, CA 95811-5216

Mailing address

1500 21St St
Sacramento, CA 95811-5216
Phone (916) 914-6354

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115000946 CA Practitioner - Clinical Social Worker 7618256694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 27, 2021 Accepting new patients
Regents of the University of California CurrentSince Sep 27, 2021 Accepting new patients

Locations

7551 Madison Ave
Citrus Hts, CA 95610
Phone (916) 904-3000

Organizations & group practices 2

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": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1043581085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-914-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-914-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JORGE",
        "middle_name": "REYNALDO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-23",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.