Individual provider Active NPI

Lupita Gomez-Hernandez

  • Student in an Organized Health Care Education/Training Program
  • Berkeley, CA
National Provider Identifier
1790676245
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3200 Adeline St
Berkeley, CA 94703-2407
Phone
(510) 601-0203
NPI assigned
Jul 14, 2025
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA Primary
Recreation Therapist 225800000X NU
Case Manager/Care Coordinator 171M00000X CA

Addresses

Primary practice location

3200 Adeline St
Berkeley, CA 94703-2407

Mailing address

17427 Via Melina
San Lorenzo, CA 94580-2644
Phone (510) 461-0890

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

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1790676245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17427 VIA MELINA",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945802644",
            "telephone_number": "510-461-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 ADELINE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032407",
            "telephone_number": "510-601-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-HERNANDEZ",
        "first_name": "LUPITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.