Individual provider Active NPI

Adrian Hernandez

  • Addiction (Substance Use Disorder) Counselor
  • San Bernardino, CA
National Provider Identifier
1841583317
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
HO504110952 Issued in CA
Practice address
5409 Chiquita LN
San Bernardino, CA 92404-2871
Phone
(909) 327-1192
NPI assigned
May 17, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X HO504110952 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X H0504110952 CA

Addresses

Primary practice location

5409 Chiquita LN
San Bernardino, CA 92404-2871

Mailing address

5409 Chiquita LN
San Bernardino, CA 92404-2871
Phone (909) 327-1192

Other identifiers 1

IdentifierTypeStateIssuer
95-2843788MedicaidCA

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

LicenseStateTypeSpecialty
H0504110952CAMDAddiction (Substance Use Disorder) Counselor
HO504110952CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1841583317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 CHIQUITA LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924042871",
            "telephone_number": "909-327-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 CHIQUITA LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924042871",
            "telephone_number": "909-327-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ADRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "HO504110952",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "H0504110952",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-2843788",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.