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General NPI Number Information
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NPI Number | 1811712185
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Entity Type | Individual
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Provider Name | CARLOS FERNANDEZ PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 40 PENNY LN STE 4
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City | WATSONVILLE
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State | CA
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Zip | 95076-6008
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Country | US
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Telephone | 831-763-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 213 LAINE ST
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City | MONTEREY
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State | CA
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Zip | 93940-1822
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Country | US
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Telephone | 408-477-4799
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT292092
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License Number State | CA
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