Stacey Melissa Hernandez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9795-C Issued in NV

Practice address

975 Kirman Ave
Reno, NV 89502-0993

Phone

(775) 786-7200

Fax

(775) 785-7003

NPI assigned

Jan 15, 2020

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

State licenses

Practice roles

Locations

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.

• Pacific Behavioral Health

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1336511179
  NPD

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1639719875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W MOANA LN STE 9",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094959",
            "telephone_number": "775-287-8270",
            "fax_number": "775-433-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 KIRMAN AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895020993",
            "telephone_number": "775-786-7200",
            "fax_number": "775-785-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "STACEY",
        "middle_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "6681-S",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9795-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Estella Hernandez, MSW
• Neida Hernandez
• Pamela Hernandez
• Patricia Hernandez
• Rafaela Gutierrez Hernandez, M.D.
• Tiara R Hernandez
• Yesenia Hernandez
• Ronald Alexander Herrera Castro
• Nancy Z Herrera Morales
• Raquel P Herrera-Trenkler, FNP-BC

• Clinical Social Worker in Reno, NV
• Providers in Reno, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.