Individual provider Active NPI

Paul Michael Hernandez

  • Addiction (Substance Use Disorder) Counselor
  • El Cajon, CA
National Provider Identifier
1932916079
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
19665 Issued in CA
Practice address
1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651
Phone
(619) 442-0277
NPI assigned
Dec 12, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 146D00000X 19665 CA
ParamedicGroup: 193200000X MULTI-SPECIALTY GROUP 146L00000X 19665 CA
Intermediate Emergency Medical TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 146M00000X 19665 CA
Basic Emergency Medical TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 146N00000X 19665 CA
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X 19665 CA
Recreation TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225800000X 19665 CA
Recreational Therapist AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 226000000X 19665 CA
Religious Nonmedical PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 374K00000X 19665 CA
Prevention ProfessionalGroup: 193200000X MULTI-SPECIALTY GROUP 405300000X 19665 CA
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 19665 CA Primary

Addresses

Primary practice location

1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651

Mailing address

1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651

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
19665CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1932916079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N JOHNSON AVE STE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N JOHNSON AVE STE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201651",
            "telephone_number": "619-442-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Personal Emergency Response Attendant",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "146M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Recreation Therapist",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "226000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Recreational Therapist Assistant",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Religious Nonmedical Practitioner",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": "CA",
            "license": "19665",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "19665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.