Individual provider Active NPI

Alicia Hernandez

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1255457867
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 40307 Issued in CA
Practice address
13800 Heacock St Ste C220
Moreno Valley, CA 92553-3363
Phone
(951) 653-1800
NPI assigned
Mar 22, 2007
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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 MFC 40307 CA Primary

Addresses

Primary practice location

13800 Heacock St Ste C220
Moreno Valley, CA 92553-3363

Mailing address

879 W 190TH St Ste 300
Gardena, CA 90248-4223
Phone (310) 323-6887

Other practice location 1

19401 S Vermont Ave
Suite a-200
Torrance, CA 90502-1029
Phone (310) 323-6887

Other practice location 2

879 W 190th St Ste 300
Gardena, CA 90248-4223
Phone (310) 323-6887

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
MFC 40307CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. CurrentSince May 1, 2021 Accepting new patients
Special Service for Groups, Inc. PastSince Jan 7, 2024 Accepting new patients
Special Service for Groups, Inc. Past Accepting new patients

Locations

13800 Heacock St
Ste C220
Moreno Valley, CA 92553
Phone (951) 243-4192

13800 Heacock St
Ste D111
Moreno Valley, CA 92553
Phone (951) 243-4192

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1255457867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 W 190TH ST STE 300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484223",
            "telephone_number": "310-323-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 HEACOCK ST STE C220",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533363",
            "telephone_number": "951-653-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19401 S Vermont Ave",
            "address_2": "SUITE A-200",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905021029",
            "country_code": "US",
            "telephone_number": "310-323-6887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "879 W 190th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484223",
            "country_code": "US",
            "telephone_number": "310-323-6887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 40307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.