Individual provider Active NPI

Mayra Alejandra Hernandez, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1114215217
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW84859 Issued in CA
Practice address
11303 W Washington Blvd Ste 200
Los Angeles, CA 90066-6003
Phone
(310) 482-3200
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW84859 CA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

11303 W Washington Blvd Ste 200
Los Angeles, CA 90066-6003

Mailing address

11303 W Washington Blvd Ste 200
Los Angeles, CA 90066-6003
Phone (310) 482-3200

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

State licenses

LicenseStateTypeSpecialty
LCSW84859CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1114215217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11303 W WASHINGTON BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666003",
            "telephone_number": "310-482-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11303 W WASHINGTON BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666003",
            "telephone_number": "310-482-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MAYRA",
        "middle_name": "ALEJANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW84859",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.