Individual provider Active NPI

Bao Her, PHD

  • Psychologist
  • Coalinga, CA
National Provider Identifier
1134602865
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY35610 Issued in CA
Practice address
24511 W Jayne Ave
Coalinga, CA 93210-9503
Phone
(559) 934-8212
NPI assigned
Sep 9, 2018
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY35610 CA Primary

Addresses

Primary practice location

24511 W Jayne Ave
Coalinga, CA 93210-9503

Mailing address

8260 Longleaf Dr BLDG C
Elk Grove, CA 95758-1322

Other practice location 1

8260 Longleaf Dr Bldg C
Elk Grove, CA 95758-1322
Phone (559) 934-8212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY35610CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Mar 1, 2025 Accepting new patients
Department of State Hospitals CurrentSince Mar 1, 2025 Accepting new patients

Locations

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

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, 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": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1134602865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 LONGLEAF DR BLDG C",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24511 W JAYNE AVE",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932109503",
            "telephone_number": "559-934-8212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8260 Longleaf Dr Bldg C",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957581322",
            "country_code": "US",
            "telephone_number": "559-934-8212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HER",
        "first_name": "BAO",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-09",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY35610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coalinga, CA

Sources for this page

Verify at the official NPI Registry.