Sergio Felipe Hernandez
Individual provider Active NPI Marriage & Family Therapist · San Jose, CA
NPI 1386247161 · NPPES record last updated Aug 15, 2022
Key facts
- NPI
- 1386247161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- AMFT120548 (CA)
- Practice address
- 6203 San Ignacio Ave Ste 150
San Jose, CA 95119-1371 - Phone
- (408) 284-9080
- NPI assigned
- Nov 16, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Imperial Valley Family Care Medical Group a P C
Practice addresses (Care Compare)
1600 S Imperial Ave
Suite 5
El Centro, CA 92243-4242
Phone (760) 890-6203
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250814004386 | CA | Practitioner - Marriage and Family Therapist | 0840799193 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120548 | CA | MD | Mental Health Counselor |
| AMFT120548 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imperial Valley Family Care Medical Group Apc | Current |
Accepting new patients | |
| Imperial Valley Family Care Medical Group, Apc | Current |
Accepting new patients |
Locations
125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100
1600 S Imperial Ave
Ste 5
El Centro, CA 92243
Phone (442) 283-5861
516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 120548 | CA | |
| Marriage & Family Therapist | 106H00000X | AMFT120548 | CA | Yes |
Addresses
Primary practice location
6203 San Ignacio Ave Ste 150
San Jose, CA 95119-1371
Mailing address
6203 San Ignacio Ave Ste 150
San Jose, CA 95119-1371
Phone (408) 284-9080
Other providers in San Jose, CA
- Roberto Hernandez
- Rosemarie Hernandez
- Ruby Hernandez
- Salvador Hernandez
- Sandra Ann Hernandez
- Stephanie Hernandez
- Stephanie Sumaya Hernandez
- Sunshine Love Hernandez
- Susana Hernandez
- Victoria Hernandez
All providers in San Jose, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.