Healthcare Provider Details

I. General information

NPI: 1720996382
Provider Name (Legal Business Name): MARIA FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 SNELL AVE
SAN JOSE CA
95123-4740
US

IV. Provider business mailing address

420 CALERO AVE
SAN JOSE CA
95123-4240
US

V. Phone/Fax

Practice location:
  • Phone: 408-347-6350
  • Fax:
Mailing address:
  • Phone: 408-347-7686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: