Active NPI
Vivian Hernandez, MD
- Pediatrics Physician
- Fresno, CA
National Provider Identifier
1699889766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A42420
- Practice address
- 4770 W Herndon Ave
Fresno, CA 93722-8402 - Phone
- (559) 271-6365
- Fax
- (559) 271-6326
- NPI assigned
- Aug 18, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A42420 | CA | Primary |
Addresses
Primary practice location
4770 W Herndon Ave
Fresno, CA 93722-8402
Mailing address
4770 W Herndon Ave
Fresno, CA 93722-8402
Phone (559) 271-6365
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A424200 | Medicaid | CA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A42420 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Foundation Medical Group | Past | Accepting new patients | |
| Fresno Community Hospital and Medical Center | 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.
-
dba Sante' Foundation Medical Group
- Internal Medicine Physician
- Fresno, CA
- NPI 1811258510
-
dba Community Regional Medical Center
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196899200000",
"number": "1699889766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4770 W HERNDON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937228402",
"telephone_number": "559-271-6365",
"fax_number": "559-271-6326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 W HERNDON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937228402",
"telephone_number": "559-271-6365",
"fax_number": "559-271-6326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "VIVIAN",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A42420",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A424200",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.