Individual provider Active NPI

Devanne Annette Hernandez

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1366849085
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
98249 Issued in CA
Practice address
1500 S Olive St FL 5
Los Angeles, CA 90015-3023
Phone
(213) 588-0367
NPI assigned
Nov 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 75140 CA
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 98249 CA Primary

Addresses

Primary practice location

1500 S Olive St FL 5
Los Angeles, CA 90015-3023

Mailing address

1500 S Olive St FL 5
Los Angeles, CA 90015-3023
Phone (213) 588-0367

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
I20260313000053 CA Practitioner - Marriage and Family Therapist 0840773271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910

15892 Caterpillar Dr
Fontana, CA 92336-5588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
98249CAMDMarriage & Family Therapist
75140CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services Marriage & Family Therapist CurrentSince Feb 1, 2026 Accepting new patients
Pediatric and Family Medical Center PastSince Mar 28, 2021 Accepting new patients

Locations

3610 Central Ave
Ste 500
Riverside, CA 92506
Phone (442) 327-9311

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1366849085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S OLIVE ST FL 5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153023",
            "telephone_number": "213-588-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S OLIVE ST FL 5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153023",
            "telephone_number": "213-588-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "DEVANNE",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "75140",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.