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General NPI Number Information
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NPI Number | 1811380322
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Entity Type | Individual
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Provider Name | GABRIEL FERNANDEZ N.P.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2015
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 7212 ORANGETHORPE AVE SUITE 9A
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City | BUENA PARK
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State | CA
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Zip | 90621-3341
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Country | US
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Telephone | 714-503-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 2024 E COMMONWEALTH AVE APT C
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City | FULLERTON
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State | CA
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Zip | 92831-4841
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Country | US
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Telephone | 510-648-6377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 738583
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95001941
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License Number State | CA
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