Healthcare Provider Details

I. General information

NPI: 1922918788
Provider Name (Legal Business Name): ESTEFANIA GUADALUPE FERNANDEZ FARIAS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4929 CLOVER PL
RANCHO CUCAMONGA CA
91737-2470
US

IV. Provider business mailing address

4929 CLOVER PL
RANCHO CUCAMONGA CA
91737-2470
US

V. Phone/Fax

Practice location:
  • Phone: 707-479-2591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number37381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: