Individual provider Active NPI

Adriana Hermosillo, M.S., LMFT

  • Marriage & Family Therapist
  • Victorville, CA
National Provider Identifier
1053701573
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117313 Issued in CA
Practice address
12625 Hesperia Rd
Victorville, CA 92395-7720
Phone
(760) 995-8300
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 117313 CA Primary

Addresses

Primary practice location

12625 Hesperia Rd
Victorville, CA 92395-7720

Mailing address

3031 S Vermont Ave
Los Angeles, CA 90007-3033
Phone (323) 373-2400

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
I20240129004022 CA Practitioner - Marriage and Family Therapist 2466805114 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
117313CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
County of San Bernardino CurrentSince Jan 26, 2025 Accepting new patients
County of San Bernardino CurrentSince Jan 26, 2025 Accepting new patients
County of San Bernardino Current Accepting new patients

Locations

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

12625 Hesperia Rd
Victorville, CA 92395
Phone (760) 955-1777

Organizations & group practices 4

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": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1053701573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073033",
            "telephone_number": "323-373-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957720",
            "telephone_number": "760-995-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMOSILLO",
        "first_name": "ADRIANA",
        "credential": "M.S., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.