Individual provider Active NPI

Monica T Hernandez, SUDRC

  • Addiction (Substance Use Disorder) Counselor
  • Seaside, CA
National Provider Identifier
1992471528
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
10859 Issued in CA
Practice address
1201 Echo Ave
Seaside, CA 93955-3719
Phone
(831) 524-6547
Fax
(831) 753-5169
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 10859 CA Primary

Addresses

Primary practice location

1201 Echo Ave
Seaside, CA 93955-3719

Mailing address

609 West St
Hollister, CA 95023-3827
Phone (831) 524-6547

Other identifiers 1

IdentifierTypeStateIssuer
10859OtherCASUDRC

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
10859CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1992471528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 WEST ST",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233827",
            "telephone_number": "831-524-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ECHO AVE",
            "city": "SEASIDE",
            "state": "CA",
            "postal_code": "939553719",
            "telephone_number": "831-524-6547",
            "fax_number": "831-753-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MONICA",
        "middle_name": "T",
        "credential": "SUDRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "10859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUDRC",
            "identifier": "10859",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.