Healthcare Provider Details

I. General information

NPI: 1548042658
Provider Name (Legal Business Name): FERNANDA ARTIGAS HAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14515 HAMLIN ST
VAN NUYS CA
91411-1686
US

IV. Provider business mailing address

14515 HAMLIN ST STE 102
VAN NUYS CA
91411-1694
US

V. Phone/Fax

Practice location:
  • Phone: 818-989-7475
  • Fax:
Mailing address:
  • Phone: 818-374-6901
  • Fax: 818-908-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number18130
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: