JUAN JOSE HERNANDEZ-CODALLOS – Clinical Social Worker, NPI 1740613306

Clinical Social Worker

JUAN JOSE HERNANDEZ-CODALLOS is a healthcare provider. based in Cheyenne, Wyoming. specializing in Clinical Social Worker. They hold a License No. 92529 (CA). The NPI Number for JUAN JOSE HERNANDEZ-CODALLOS is 1740613306

Main info

Male

10 Years Of Experience

Accepts Medicare Assignment

Name

JUAN JOSE HERNANDEZ-CODALLOS

NPI

1740613306

Phone

(307) 426-4728

Address

510 W 29TH ST

Enumeration Date

17 August 2013

Last Update Date

31 July 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3077458915

Graduation Year

2016 (10 years ago)

PAC ID

1557795713

Group Practice PAC ID

7911993662

Professional Enrollment ID

I20191220000851

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience58

Completeness75

Years active:12State licenses:1Digital endpointsOther names

Provider Addresses for JUAN JOSE HERNANDEZ-CODALLOS

510 W 29TH ST
CHEYENNE, WY 820012760
Phone: (307) 426-4728
Type: Mailing
1263 N 15TH ST
LARAMIE, WY 82072
Phone: (307) 745-8915
Type: Location
1263 N 15th St
Laramie, WY 82072
Phone: (307) 745-8915
Type: Location
615 ROGER CANYON RD
LARAMIE, WY 820728902
Phone: (209) 918-8761
Type: Location
PO BOX 1733
LARAMIE, WY 820731733
Phone:
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 82001)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 7911993662View full group profile

Name	Specialty	State
ALEXANDRA KANE (LCSW)	-	WY
Unknown Individual	-	WY
BRENDA LEE ALEXANDER-O'NEIL (PMHNP-BC)	Nurse Practitioner	OH
MRS. AIMEE FOSTER (PSY.D)	-	WY
HEATHER MADRID (LCSW)	-	WY