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NPI Code Detail

MEDICARE: AMANDA FERNANDEZ

MEDICARE: AMANDA FERNANDEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1295274363
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA FERNANDEZ
Provider Business Mailing Address
First Line : 44065 MARGARITA RD
Second Line :
City : TEMECULA
State : CA
Zip : 92592-2741
Country : US
Telephone Number : 866-727-8274
Fax Number :
Provider Business Practice Location Address
First Line : 44065 MARGARITA RD
Second Line :
City : TEMECULA
State : CA
Zip : 92592-2741
Country : US
Telephone Number : 866-727-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2017
Last Update Date : 03/03/2020

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Directions to “ AMANDA FERNANDEZ ” Practice Location

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