Active NPI
Max Hernandez, OTR
- Occupational Therapist
- Apple Valley, CA
National Provider Identifier
1356738066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 22993
- Practice address
- 18300 US Highway 18
Apple Valley, CA 92307-2255 - Phone
- (760) 242-2311
- NPI assigned
- Apr 20, 2015
- Last updated
- Oct 2, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 114396 | TX | |
| Occupational Therapist | 225X00000X | 22993 | CA | Primary |
Addresses
Primary practice location
18300 US Highway 18
Apple Valley, CA 92307-2255
Mailing address
18300 US Highway 18
Apple Valley, CA 92307-2255
Phone (760) 242-2311
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 |
|---|---|---|---|
| 22993 | CA | MD | Family Medicine Physician |
| 114396 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664668800000",
"number": "1356738066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18300 US HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923072255",
"telephone_number": "760-242-2311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 US HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923072255",
"telephone_number": "760-242-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "MAX",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-20",
"last_updated": "2022-10-02",
"certification_date": "2022-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114396",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "22993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.