Individual provider Active NPI

Mikaela Marie Vierra, ASW

  • Student in an Organized Health Care Education/Training Program
  • Corcoran, CA
National Provider Identifier
1053965012
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
900 Quebec Ave
Corcoran, CA 93212-9715
Phone
(559) 992-7100
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

900 Quebec Ave
Corcoran, CA 93212-9715

Mailing address

311 Douty St
Hanford, CA 93230
Phone (559) 583-9300

Other practice location 1

311 N Douty St
Hanford, CA 93230-3951
Phone (559) 583-9300

Other practice location 2

222 Keith St
Hanford, CA 93230-2910
Phone (559) 583-7800

Other practice location 3

11517 15th ave
Hanford, CA 93230-9323
Phone (559) 583-9300

Other identifiers 1

IdentifierTypeStateIssuer
390200000XOtherCDCR

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

Practice roles

OrganizationSpecialtyStatusNew patients
Champions Recovery Alternative Programs, Inc. PastSince Jul 23, 2023 Accepting new patients

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1053965012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DOUTY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "93230",
            "telephone_number": "559-583-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 QUEBEC AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129715",
            "telephone_number": "559-992-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 N Douty St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932303951",
            "country_code": "US",
            "telephone_number": "559-583-9300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 Keith St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932302910",
            "country_code": "US",
            "telephone_number": "559-583-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11517 15th ave",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932309323",
            "country_code": "US",
            "telephone_number": "559-583-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIERRA",
        "first_name": "MIKAELA",
        "middle_name": "MARIE",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDCR",
            "identifier": "390200000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corcoran, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.