Individual provider Active NPI

Jessica Hidalgo

  • Community Health Worker
  • Provo, UT
National Provider Identifier
1093281701
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1002 W 500 S
Provo, UT 84601-4145
Phone
(415) 861-0828
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1002 W 500 S
Provo, UT 84601-4145

Mailing address

1002 W 500 S
Provo, UT 84601-4145
Phone (415) 861-0828

Other practice location 1

1001 Sneath Ln Ste 200
San Bruno, CA 94066-2349
Phone (650) 243-9849

Other practice location 2

50 Shrader St
San Francisco, CA 94117
Phone (415) 668-4166

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
Progress Foundation Past Accepting new patients
Progress Foundation Past Accepting new patients

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": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1093281701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 W 500 S",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846014145",
            "telephone_number": "415-861-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 W 500 S",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846014145",
            "telephone_number": "415-861-0828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Sneath Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Bruno",
            "state": "CA",
            "postal_code": "940662349",
            "country_code": "US",
            "telephone_number": "650-243-9849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Shrader St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94117",
            "country_code": "US",
            "telephone_number": "415-668-4166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIDALGO",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.