Larry Gregory Heredia, ACSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

87151 Issued in CA

Practice address

784 W Holland Ave
Clovis, CA 93612-4800

Phone

(559) 538-1230

NPI assigned

Jan 25, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1174300412
  NPD (past)

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1275249054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 E SIERRA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937103928",
            "telephone_number": "559-304-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 W HOLLAND AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936124800",
            "telephone_number": "559-538-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "524 S Trinity St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937061873",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4041 Plaza Dr E",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937021342",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1828 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211008",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N Blackstone Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937011939",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Barstow Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937042156",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1553 Santa Clara St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937063447",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "LARRY",
        "middle_name": "GREGORY",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "87151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rea Henrique, D.C.
• Thomas Henrique, D.C.
• Rose Pahoua Her
• Sarah Her
• Kimberly Herbert
• Leta Hering, PNP
• Heritage Crossing Fresno Inc.
• Hillary Danielle Herman
• Saray Hernandez-Martinez
• Maria Hernandez-Tejeda

• Social Worker in Clovis, CA
• Providers in Clovis, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.