Active NPI
Andrea Gisselle Herrera
- Rehabilitation Practitioner
- Gardena, CA
National Provider Identifier
1609568179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 108 W Victoria St
Gardena, CA 90248-3523 - Phone
- (310) 715-2020
- NPI assigned
- May 23, 2023
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
108 W Victoria St
Gardena, CA 90248-3523
Mailing address
108 W Victoria St
Gardena, CA 90248-3523
Phone (310) 715-2020
Other practice location 1
525 W Avenue P4
Palmdale, CA 93551-3743
Phone (661) 272-9996
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Care Resource Center, Inc. | Past | Accepting new patients | |
| All for Kids Organization | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Palmdale, CA
- NPI 1609902436
-
- Community/Behavioral Health Agency
- Chatsworth, CA
- NPI 1750948758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757376000000",
"number": "1609568179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 W VICTORIA ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483523",
"telephone_number": "310-715-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W VICTORIA ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483523",
"telephone_number": "310-715-2020"
}
],
"practiceLocations": [
{
"address_1": "525 W Avenue P4",
"address_purpose": "LOCATION",
"city": "Palmdale",
"state": "CA",
"postal_code": "935513743",
"country_code": "US",
"telephone_number": "661-272-9996",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERRERA",
"first_name": "ANDREA",
"middle_name": "GISSELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-23",
"last_updated": "2025-09-09",
"certification_date": "2025-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.