Andrea Hernandez

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

42786 Issued in CA

Practice address

1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984

Phone

(909) 932-1069

Fax

(909) 932-1087

NPI assigned

May 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Inland Valley Drug and Alcohol Recovery Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Bernardino, CA
  • NPI 1053180307
  NPD
• Inland Valley Drug and Alcohol Recovery Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Colton, CA
  • NPI 1740059088
  NPD

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1144078635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24550 E LITTLE THIRD ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924104936",
            "telephone_number": "909-413-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY BLDG E",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864984",
            "telephone_number": "909-932-1069",
            "fax_number": "909-932-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "42786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberley Henry
• Kristina Henry, SLPA
• John Hephner
• Herbert Y H & Jean C N King
• Amanda Alyssa Hernandez
• Diana E Hernandez
• Maria Hernandez
• Marisol Hernandez
• Regina Marie Hernandez, LCSW
• Rene Hernandez

• Licensed Psychiatric Technician in Upland, CA
• Providers in Upland, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.