PHILIP HERSHON (NPI# 1215485487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215485487 |
| Entity Type | Individual |
| Full Name | PHILIP HERSHON |
| Practice Address |
1108 S El Camino Real San Mateo CA 94402-2804 |
| Practice Telephone | 6504580026 |
| Practice Fax Number | 6504580027 |
| Mailing Telephone | 6504580026 |
| Mailing Fax Number | 6504580027 |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1108 S EL CAMINO REAL |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720204506 | David Dean Johnson | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2007-04-18 |
| 1548876337 | Jenae Aesha Richardson | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2020-09-17 |
| 1982148557 | Michael Krechevsky | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-12-15 |
| 1992248884 | Cheng Hsu | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-11-23 |
| 1104283167 | Bryan Robert Milonja | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-01-21 |
| 1669855730 | Patrick Kerwin | Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2015-07-07 |
| 1740673441 | Shannon Diaz | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2015-03-05 |
| 1063831337 | Sarah Schaafsma | Marriage & Family Therapist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2014-04-15 |
| 1174952378 | Mary Brennan | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2013-11-07 |
| 1093142309 | Nga Ly | Nurse Practitioner | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2013-10-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
| Find all providers in zip 94402 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306220173 | Anna Matkowski | Peer Specialist | 2125 Meadow View Pl, San Mateo, CA 94401-3467 | 2015-07-11 |
| 1982148557 | Michael Krechevsky | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-12-15 |
| 1992248884 | Cheng Hsu | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477629 | Karen J Pompa | Peer Specialist | 2605 E Date Palm Paseo Apt 2194, Ontario, CA 91764-4670 | 2020-11-05 |
| 1033710231 | Marcus Kujawa | Peer Specialist | 85 Ramona Expy Ste 13, Perris, CA 92571-7014 | 2020-11-04 |
| 1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
| 1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
| 1497364848 | Marissa Adrianna Garza | Peer Specialist | 1502 Verona Ct, Salinas, CA 93905-2249 | 2020-07-30 |
| 1235765801 | Jill Nina Bierman | Peer Specialist | 25322 Via Piedra Roja, Laguna Niguel, CA 92677-1824 | 2020-03-16 |
| 1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
| 1437783180 | Samuel Guadron Rosales | Peer Specialist | 658 E Brier Dr Ste 250, San Bernardino, CA 92408-2875 | 2020-03-02 |
| 1356973234 | Salina Sheoli Romero | Peer Specialist | 40 West G Street Ste. B, Los Banos, CA 93635 | 2020-02-07 |
| 1578103313 | Charles Winfield Eproson Jr. | Peer Specialist | 4545 Georgetown Pl Ste D, Stockton, CA 95207-6229 | 2020-01-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.