Chantel Rodriguez Hernandez

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

SUDR9888 Issued in CA

Practice address

2772 S Martin L King Jr Blvd
Fresno, CA 93706-5345

Phone

(559) 265-4818

NPI assigned

Aug 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Merced, CA
  • NPI 1104982495
  NPD (past)
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Banning, CA
  • NPI 1376293407
  NPD (past)

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1609422302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 RAMBLER RD",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483351",
            "telephone_number": "209-707-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 S MARTIN L KING JR BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065345",
            "telephone_number": "559-265-4818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1343 W Main St Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953404438",
            "country_code": "US",
            "telephone_number": "209-725-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "CHANTEL",
        "middle_name": "RODRIGUEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "SUDR9888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADTP",
            "identifier": "SUDR9888",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlyn Mai Xue Hernandez
• Carmen Hernandez
• Carolina Hernandez
• Cathy Louise Hernandez
• Celina Maria Hernandez
• Christina Hernandez
• Clancy Hernandez
• Clarissa Anahi Hernandez
• Cristalette Anani Hernandez
• Cristina Barajas Hernandez

• All providers in Fresno, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.