Individual provider Active NPI

Elizabeth J Hayes-Hernandez, MFT #49173

  • Marriage & Family Therapist
  • Fairfield, CA
National Provider Identifier
1235294141
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49173 Issued in CA
Practice address
275 Beck Ave
Fairfield, CA 94533-6804
Phone
(707) 784-4933
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 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 49173 CA Primary

Addresses

Primary practice location

275 Beck Ave
Fairfield, CA 94533-6804

Mailing address

275 Beck Ave
Fairfield, CA 94533-6804
Phone (707) 738-3377

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
I20240726003695 CA Practitioner - Marriage and Family Therapist 1456897321 Practice locations: Vacaville, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49173CAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1235294141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BECK AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336804",
            "telephone_number": "707-738-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BECK AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336804",
            "telephone_number": "707-784-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES-HERNANDEZ",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "MFT #49173",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.