Active NPI
Mayra Hernandez
- Mental Health Counselor
- Modesto, CA
National Provider Identifier
1801443486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 16359
- Practice address
- 707 14TH St
Modesto, CA 95354-2506 - Phone
- (209) 412-8972
- NPI assigned
- Aug 20, 2019
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Mental Health Counselor | 101YM0800X | 16359 | CA | Primary |
Addresses
Primary practice location
707 14TH St
Modesto, CA 95354-2506
Mailing address
1108 S Berry Dr
Madera, CA 93637-8847
Phone (707) 513-6780
Other practice location 1
3626 Balboa St
San Francisco, CA 94121-2604
Phone (415) 668-5955
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 |
|---|---|---|---|
| 16359 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1801443486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 S BERRY DR",
"city": "MADERA",
"state": "CA",
"postal_code": "936378847",
"telephone_number": "707-513-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 14TH ST",
"city": "MODESTO",
"state": "CA",
"postal_code": "953542506",
"telephone_number": "209-412-8972"
}
],
"practiceLocations": [
{
"address_1": "3626 Balboa St",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941212604",
"country_code": "US",
"telephone_number": "415-668-5955",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "MAYRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "16359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.