Individual provider Active NPI

Sylvia Mellisa Hernandez, CADCII ICADC

  • Addiction (Substance Use Disorder) Counselor
  • Riverside, CA
National Provider Identifier
1881857944
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A057400620 Issued in CA
Practice address
4000 Orange St
Riverside, CA 92501-3613
Phone
(951) 824-0580
NPI assigned
Jul 8, 2008
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA
Addiction (Substance Use Disorder) Counselor 101YA0400X CI16720518 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X 330015CN CA
Addiction (Substance Use Disorder) Counselor 101YA0400X A057400620 CA Primary
Case Manager/Care Coordinator 171M00000X A057400620 CA

Addresses

Primary practice location

4000 Orange St
Riverside, CA 92501-3613

Mailing address

3236 Washington St
Riverside, CA 92504-4533
Phone (951) 824-0580

Other practice location 1

8310 Baxter Way
Riverside, CA 92504-4302
Phone (951) 689-9366

Other practice location 2

17270 Roosevelt St
Riverside, CA 92508

Other practice location 3

17270 Roosevelt St
Riverside, CA 92508

Other practice location 4

18612 Santa Ana Ave
Bloomington, CA 92316-2639
Phone (909) 421-7120 ext. 156

Other practice location 5

1889 W Redlands Blvd Bldg 9
Redlands, CA 92373
Phone (909) 501-5167

Other identifiers 1

IdentifierTypeStateIssuer
33352OtherCADRUG MEDI-CAL

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
330015CNCAMDAddiction (Substance Use Disorder) Counselor
A057400620CAMDAddiction (Substance Use Disorder) Counselor
CI16720518CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ywca Born Free Addiction (Substance Use Disorder) Past Accepting new patients
Mfi Recovery Center PastSince Jul 23, 2023 Accepting new patients
Aegis Treatment Centers, LLC PastSince Oct 1, 2019 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1881857944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 WASHINGTON ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044533",
            "telephone_number": "951-824-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013613",
            "telephone_number": "951-824-0580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8310 Baxter Way",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925044302",
            "country_code": "US",
            "telephone_number": "951-689-9366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17270 Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "92508",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17270 Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "92508",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18612 Santa Ana Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "CA",
            "postal_code": "923162639",
            "country_code": "US",
            "telephone_number": "909-421-7120 x156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1889 W Redlands Blvd Bldg 9",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "92373",
            "country_code": "US",
            "telephone_number": "909-501-5167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "SYLVIA",
        "middle_name": "MELLISA",
        "credential": "CADCII ICADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI16720518",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "330015CN",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A057400620",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "A057400620",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "33352",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.