Individual provider Active NPI

David S Hernandez

  • Addiction (Substance Use Disorder) Counselor
  • Blythe, CA
National Provider Identifier
1184294589
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
9826 18TH Ave
Blythe, CA 92225-9229
Phone
(619) 321-9845
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

9826 18TH Ave
Blythe, CA 92225-9229

Mailing address

1100 N D St
San Bernardino, CA 92410-3524
Phone (909) 381-3774

Other names 1

  • David S Hernandez Other name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Veterans Alcohol Rehabilitation Program, Inc.-Varp, Inc. CurrentSince Oct 15, 2023 Accepting new patients
Veterans Alcohol Rehabilitation Program, Inc.- Varp, Inc. PastSince Jul 4, 2021 Accepting new patients

Locations

9826 18th Ave
Blythe, CA 92225
Phone (760) 550-4684

1100 N D St
San Bernardino, CA 92410
Phone (909) 884-0840

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1184294589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103524",
            "telephone_number": "909-381-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9826 18TH AVE",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922259229",
            "telephone_number": "619-321-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "DAVID",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "HERNANDEZ",
            "middle_name": "S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blythe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.