Individual provider Active NPI

Jennifer Ann Hernandez, LCSW

  • Clinical Social Worker
  • Fountain Valley, CA
National Provider Identifier
1740793751
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW98689 Issued in CA
Practice address
18350 Mount Langley St
Fountain Valley, CA 92708-6900
Phone
(714) 450-4118
NPI assigned
Nov 13, 2017
Last updated
May 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW98689 CA Primary

Addresses

Primary practice location

18350 Mount Langley St
Fountain Valley, CA 92708-6900

Mailing address

18350 Mount Langley St
Fountain Valley, CA 92708-6900
Phone (714) 450-4118

Other practice location 1

762 Cypress St
San Dimas, CA 91773
Phone (909) 599-1227

Other practice location 2

2008 N Garey Ave
Pomona, CA 91767-2722
Phone (099) 623-6131

Other practice location 3

867 N Fair Oaks Ave
Pasadena, CA 91103-3050
Phone (626) 798-6793

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW98689CAMDClinical Social Worker
98689CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Mental Health Center PastSince Nov 23, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1740793751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086900",
            "telephone_number": "714-450-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086900",
            "telephone_number": "714-450-4118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "762 Cypress St",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "91773",
            "country_code": "US",
            "telephone_number": "909-599-1227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2008 N Garey Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672722",
            "country_code": "US",
            "telephone_number": "099-623-6131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "867 N Fair Oaks Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911033050",
            "country_code": "US",
            "telephone_number": "626-798-6793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW98689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.

Verify at the official NPI Registry.