Individual provider Active NPI

Sandra Marcela Herrera

  • Mental Health Counselor
  • West Sacramento, CA
National Provider Identifier
1174655773
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3050 Beacon Blvd Ste 103
West Sacramento, CA 95691-3467
Phone
(530) 230-1285
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CPT8635 CA
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3050 Beacon Blvd Ste 103
West Sacramento, CA 95691-3467

Mailing address

3050 Beacon Blvd Ste 103
West Sacramento, CA 95691-3467
Phone (530) 230-1285

Other practice location 1

1113 Potrero Cir
Suisun City, CA 94585-4151
Phone (707) 426-0772

Other identifiers 1

IdentifierTypeStateIssuer
CPT8635OtherCAPHLEBOTOMIST

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
CPT8635CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1174655773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 BEACON BLVD STE 103",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913467",
            "telephone_number": "530-230-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 BEACON BLVD STE 103",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913467",
            "telephone_number": "530-230-1285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Potrero Cir",
            "address_purpose": "LOCATION",
            "city": "Suisun City",
            "state": "CA",
            "postal_code": "945854151",
            "country_code": "US",
            "telephone_number": "707-426-0772",
            "fax_number": "707-426-0772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "SANDRA",
        "middle_name": "MARCELA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "CPT8635",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHLEBOTOMIST",
            "identifier": "CPT8635",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.