Individual provider Active NPI

Mayra Y Hernandez

  • Marriage & Family Therapist
  • El Monte, CA
National Provider Identifier
1194050302
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT110361 Issued in CA
Practice address
11429 Valley Blvd
El Monte, CA 91731-3229
Phone
(626) 993-3000
NPI assigned
Oct 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT110361 CA Primary

Addresses

Primary practice location

11429 Valley Blvd
El Monte, CA 91731-3229

Mailing address

14868 Sydney Ave
Fontana, CA 92336-0629
Phone (909) 767-1474

Other practice location 1

1084 Athens Way
Upland, CA 91786-7544
Phone (951) 990-5419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110004629 CA Practitioner - Marriage and Family Therapist 2062863301 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT110361CAMDMarriage & Family Therapist
110361CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Foothill Family Service PastSince Oct 20, 2019 Accepting new patients
Foothill Family Service - Hudson PastSince Oct 20, 2019 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

10532 Acacia St
Ste B4
Rch Cucamonga, CA 91730
Phone (909) 325-3766

Organizations & group practices 3

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": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1194050302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14868 SYDNEY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360629",
            "telephone_number": "909-767-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11429 VALLEY BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917313229",
            "telephone_number": "626-993-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1084 Athens Way",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917867544",
            "country_code": "US",
            "telephone_number": "951-990-5419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MAYRA",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT110361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.