Eliseo Antonio Heredia Jr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1539 McHenry Ave
Modesto, CA 95350-4528

Phone

(209) 758-0825

NPI assigned

Feb 16, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Sierra Vista Child & Family Services

  • Community/Behavioral Health Agency
  • Modesto, CA
  • NPI 1477686350
  NPD (past)

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1821537366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 MCHENRY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504528",
            "telephone_number": "209-758-0825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2524 Finney Rd",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953589765",
            "country_code": "US",
            "telephone_number": "209-550-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "ELISEO",
        "middle_name": "ANTONIO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2024-12-02",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nouche Her
• Pangdee Her, OTR/L
• Shoua Her, NP
• Hera OBGYN Medical Group, Inc.
• Marisol Heras
• Heritage Care Staffing Services, LLC
• Brian James Herline, DC
• Hermes Guardian Transport
• Martin Hermes
• Natasha Hermis, PHARM.D.

• Mental Health Counselor in Modesto, CA
• Providers in Modesto, CA by specialty
• Mental Health Counselor in California

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

Verify at the official NPI Registry.