Herson Mojica, PSYCHOLOGIST

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

2012909 Issued in CA

Practice address

920 E Broadway
Glendale, CA 91205-1204

Phone

(818) 242-9481

NPI assigned

Dec 10, 2018

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)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.hersonmojica@148377.advancedmd-direct.com

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.

• Lux Psychology Inc.

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1821702648
  NPD Authorized official

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1891266367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051204",
            "telephone_number": "818-242-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051204",
            "telephone_number": "818-242-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA",
        "first_name": "HERSON",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "2012909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobile Rapid Recovery Inc
• Jimmy Moc, DPT
• Modern Hospice Care, Inc.
• Mohamed Hammam, BDS, Inc
• Mohammed Ahmeduddin DPM
• Michael Mojica
• Ella Mokhtarians
• Harold Bob Balazo Molano, LVN, COTA
• Deserie Molina
• Evelyn Molina

• Clinical Child & Adolescent Psychologist in Glendale, CA
• Providers in Glendale, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.