MEDICARE: MR. LOUIS ALFRED FERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT300537	CA

General Provider Information

NPI Number	:	1396411641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LOUIS ALFRED FERNANDEZ

Provider Business Mailing Address
First Line	:	PO BOX 255228
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95865-5228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 5TH AVE
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-5899
Country	:	US
Telephone Number	:	530-533-2233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	05/08/2026

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Directions to “ MR. LOUIS ALFRED FERNANDEZ ” Practice Location

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