Active NPI
Hermila Rendon, M.S.
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1568658789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 82971
- Practice address
- 5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193 - Phone
- (888) 588-8995
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | 82971 | CA | Primary |
Addresses
Primary practice location
5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193
Mailing address
840 Third Ave Apt 14
Chula Vista, CA 91911-1306
Phone (619) 980-6245
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82971 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foresight Mental Health | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1568658789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 THIRD AVE APT 14",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919111306",
"telephone_number": "619-980-6245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR STE 309",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205193",
"telephone_number": "888-588-8995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDON",
"first_name": "HERMILA",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-20",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"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": "82971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.