Marisa Hernandez

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

31760 Casino Dr Ste 100
Lake Elsinore, CA 92530-4561

Phone

(951) 471-4600

Fax

(951) 471-4623

NPI assigned

Jan 16, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• County of Riverside

  • Community/Behavioral Health Agency
  • Lake Elsinore, CA
  • NPI 1982094629
  NPD (past)

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1386455541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31760 CASINO DR STE 100",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304561",
            "telephone_number": "951-471-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31760 CASINO DR STE 100",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304561",
            "telephone_number": "951-471-4600",
            "fax_number": "951-471-4623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40925 County Center Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925916054",
            "country_code": "US",
            "telephone_number": "951-600-6420",
            "fax_number": "951-600-6419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Elia Hernandez-Gomez, LCSW
• Carmina Hernandez
• Diana Suzana Hernandez
• Erika Hernandez
• Jose R Hernandez
• Natalie Hernandez
• Victoria Hernandez
• Jimmie Herron, CADC-CAS
• Hillside Senior Living
• Makenna Hindson

• Peer Specialist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.