Individual provider Active NPI

Israel Valdez Hernandez, LCSW

  • Clinical Social Worker
  • Hemet, CA
National Provider Identifier
1073842662
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100225 Issued in CA
Practice address
1791 W Acacia Ave
Hemet, CA 92545-3797
Phone
(951) 765-5100
NPI assigned
Dec 10, 2009
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 77223 CA
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 100225 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Rehabilitation Practitioner 225400000X CA

Addresses

Primary practice location

1791 W Acacia Ave
Hemet, CA 92545-3797

Mailing address

3625 14TH St
Riverside, CA 92501-3815
Phone (951) 955-1540

Other practice location 1

108 W Victoria St
Gardena, CA 90248-3523
Phone (310) 715-2020

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
I20220922002381 CA Practitioner - Clinical Social Worker 0446635718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

162 N Santa Fe St
Hemet, CA 92543-4451
Phone (951) 652-8107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77223CAMDMental Health Counselor
100225CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Oct 27, 2023 Accepting new patients
Inland Psychiatric Medical Group, Inc. CurrentSince Aug 25, 2022 Accepting new patients
Inland Psychiatric Medical Group, Inc Clinical CurrentSince Aug 25, 2022 Accepting new patients
Inland Psychiatric Medical Group, Inc. Clinical Current Accepting new patients

Locations

162 N Santa Fe St
Hemet, CA 92543
Phone (951) 506-9522

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1073842662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 14TH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013815",
            "telephone_number": "951-955-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 W ACACIA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925453797",
            "telephone_number": "951-765-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 W Victoria St",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902483523",
            "country_code": "US",
            "telephone_number": "310-715-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDEZ HERNANDEZ",
        "first_name": "ISRAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-10",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "77223",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100225",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.