Individual provider Active NPI

Vivian Elvira Jurado-Fernandez, NBC-HWC

  • Health & Wellness Coach
  • Bohemia, NY
National Provider Identifier
1124984844
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
120 Sussex PL Apt 13
Bohemia, NY 11716-3920
Phone
(631) 204-7381
Fax
(631) 204-7381
NPI assigned
Dec 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X Primary

Addresses

Primary practice location

120 Sussex PL Apt 13
Bohemia, NY 11716-3920

Mailing address

120 Sussex PL Apt 13
Bohemia, NY 11716-3920
Phone (631) 204-7381

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

NPI Registry JSON

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

{
    "created_epoch": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1124984844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SUSSEX PL APT 13",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117163920",
            "telephone_number": "631-204-7381",
            "fax_number": "631-204-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SUSSEX PL APT 13",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117163920",
            "telephone_number": "631-204-7381",
            "fax_number": "631-204-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURADO-FERNANDEZ",
        "first_name": "VIVIAN",
        "middle_name": "ELVIRA",
        "credential": "NBC-HWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.