Individual provider Active NPI

Jackie Hernandez

  • Rehabilitation Practitioner
  • Los Angeles, CA
National Provider Identifier
1821326836
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2500 Wilshire Blvd
Suite 500
Los Angeles, CA 90057-4303
Phone
(323) 331-8886
NPI assigned
Dec 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

2500 Wilshire Blvd
Suite 500
Los Angeles, CA 90057-4303

Mailing address

5826 1/2 Clara St
Bell Gardens, CA 90201-4771

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": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1821326836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5826 1/2 CLARA ST",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902014771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WILSHIRE BLVD",
            "address_2": "SUITE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574303",
            "telephone_number": "323-331-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JACKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.