Healthcare Provider Details

I. General information

NPI: 1770874091
Provider Name (Legal Business Name): JOVITA HERRERA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10750 4TH ST STE 150
RANCHO CUCAMONGA CA
91730-0979
US

IV. Provider business mailing address

38733 9TH ST E STE O6
PALMDALE CA
93550-2911
US

V. Phone/Fax

Practice location:
  • Phone: 909-870-8820
  • Fax:
Mailing address:
  • Phone: 909-870-8820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110170
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: