Jayden Hernandez, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2301 7TH St Ste a
Las Vegas, NM 87701-4966

Phone

(505) 454-9611

NPI assigned

Jul 11, 2024

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Male

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rio Grande Alcoholism Treatment Center Incorporated

  dba Rio Grande Alcoholism Treatment Program, Inc.

  • Substance Abuse Rehabilitation Facility
  • Taos, NM
  • NPI 1194924928
  NPD

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1659118115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PASEO DEL CANON W STE A",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716943",
            "telephone_number": "575-737-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 7TH ST STE A",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014966",
            "telephone_number": "505-454-9611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Paseo Del Canon W Ste A",
            "address_purpose": "LOCATION",
            "city": "Taos",
            "state": "NM",
            "postal_code": "875716943",
            "country_code": "US",
            "telephone_number": "575-737-5533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JAYDEN",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sallyanne Haynes
• Lea Henderson, NURSE PRACTITIONER
• Heritage Healthcare of Northern New Mexico, Inc (Heritage Home Care - Las Vegas Inc.)
• Heritage Healthcare of Northern New Mexico, Inc. (Heritage Home Care - Las Vegas Inc.)
• Allan Tilden Herman, MD
• Lydia Esther Hernandez, LISW
• Marissa Hernandez
• Rosabelle Nadine Hernandez, RPH
• Amanda Herrera
• Mark A Herrera, P.T.

• Addiction (Substance Use Disorder) Counselor in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.