Active NPI
Roberto Hernandez
- Behavior Technician
- Santa Cruz, CA
National Provider Identifier
1285069252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8030 Soquel Ave Ste 104
Santa Cruz, CA 95062-2096 - Phone
- (855) 223-7123
- NPI assigned
- Sep 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Behavior Technician | 106S00000X | Primary | ||
| Counselor | 101Y00000X | AMFT-105958 | CA |
Addresses
Primary practice location
8030 Soquel Ave Ste 104
Santa Cruz, CA 95062-2096
Mailing address
PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123
Other practice location 1
4205 W Figarden Dr
Fresno, CA 93722
Phone (559) 221-1680
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
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT-105958 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1285069252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33568",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921633568",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8030 SOQUEL AVE STE 104",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950622096",
"telephone_number": "855-223-7123"
}
],
"practiceLocations": [
{
"address_1": "4205 W Figarden Dr",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "93722",
"country_code": "US",
"telephone_number": "559-221-1680",
"fax_number": "559-221-4336",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "ROBERTO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-10",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "AMFT-105958",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.