Individual provider Active NPI

Hermila Rendon, M.S.

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1568658789
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
82971 Issued in CA
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

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
82971CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foresight Mental Health Marriage & Family Therapist PastSince Nov 19, 2023 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.

Verify at the official NPI Registry.