Active NPI
Andrea Maria Hernandez, CTRS/L
- Recreation Therapist
- Fresno, CA
National Provider Identifier
1891349700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 168
- Practice address
- 2615 E Clinton Ave
Fresno, CA 93703-2223 - Phone
- (559) 225-6100
- NPI assigned
- Jul 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 168 | OK | Primary |
Addresses
Primary practice location
2615 E Clinton Ave
Fresno, CA 93703-2223
Mailing address
2615 E Clinton Ave
Fresno, CA 93703-2223
Phone (559) 225-6100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61269 | Other | NCTRC | |
| 168 | Other | OK | OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 168 | OK | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564358400000",
"number": "1891349700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 E CLINTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937032223",
"telephone_number": "559-225-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 E CLINTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937032223",
"telephone_number": "559-225-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "ANDREA",
"middle_name": "MARIA",
"credential": "CTRS/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-29",
"last_updated": "2019-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "OK",
"license": "168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCTRC",
"identifier": "61269",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION",
"identifier": "168",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.