Active NPI
Sara Dickes Hernandez, PSY.D.
- Behavior Analyst
- San Bernardino, CA
National Provider Identifier
1770027633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- PSY18660
- Practice address
- 1638 Windsor St
San Bernardino, CA 92407-3364 - Phone
- (909) 366-9344
- NPI assigned
- Dec 12, 2016
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | PSY18660 | CA | Primary |
| Clinical Psychologist | 103TC0700X | PSY18660 | CA |
Addresses
Primary practice location
1638 Windsor St
San Bernardino, CA 92407-3364
Mailing address
1100 Hillside St
La Habra, CA 90631-2822
Phone (714) 360-3233
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18660 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Center Committed to Educate Scientifically | Behavior Analyst | Past | Accepting new patients |
| Autism Spectrum Intervention Services and Training (Asist) | 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.
-
- Behavior Analyst
- Colton, CA
- NPI 1770225609
-
- Early Intervention Provider Agency
- San Bernardino, CA
- NPI 1316343254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481500800000",
"number": "1770027633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 HILLSIDE ST",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906312822",
"telephone_number": "714-360-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1638 WINDSOR ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924073364",
"telephone_number": "909-366-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "SARA",
"middle_name": "DICKES",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-12",
"last_updated": "2016-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "PSY18660",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18660",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.