Individual provider Active NPI

Christine Nancy Hernandez, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Commerce, CA
National Provider Identifier
1811272206
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95018871 Issued in CA
Practice address
1436 Goodrich Blvd
Commerce, CA 90022-5111
Phone
(323) 725-1337
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 804617 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95018871 CA Primary

Addresses

Primary practice location

1436 Goodrich Blvd
Commerce, CA 90022-5111

Mailing address

14860 Roscoe Blvd Ste 307
Panorama City, CA 91402-4691
Phone (747) 998-0387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220317002624 CA Practitioner - Nurse Practitioner 3173918794 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians
Alliance for Wellness IncGroup PAC ID 9931355617, 58 clinicians

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

14850 Roscoe Blvd
Panorama City, CA 91402-4618
Phone (818) 787-2222

Hospital & facility affiliations

  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
804617CAMDRegistered Nurse
95018871CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance for Wellness, Inc. Psychiatric/Mental Health CurrentSince Jan 1, 2022 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Apr 30, 2022 Accepting new patients

Locations

1370 Valley Vista Dr
Ste 200
Diamond Bar, CA 91765
Phone (310) 981-8227

16260 Ventura Blvd
Ste 630
Encino, CA 91436
Phone (747) 264-9201

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

501 E Hardy St
Ste 425
Inglewood, CA 90301
Phone (310) 419-4303

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

9250 Reseda Blvd
Ste 658
Northridge, CA 91324

1410 Neotomas Ave
Fl 2
Santa Rosa, CA 95405
Phone (415) 608-6173

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

14850 Roscoe Blvd
Van Nuys, CA 91402
Phone (818) 787-2222

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1811272206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14860 ROSCOE BLVD STE 307",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024691",
            "telephone_number": "747-998-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 GOODRICH BLVD",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900225111",
            "telephone_number": "323-725-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "CHRISTINE",
        "middle_name": "NANCY",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "804617",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95018871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, CA

Sources for this page

Verify at the official NPI Registry.