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NPI Code Detail

MEDICARE: KIMBERLY A FERNANDEZ LVN

MEDICARE: KIMBERLY A FERNANDEZ LVN
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
1101YA0400XAddiction (Substance Use Disorder) Counselor178021CA

General Provider Information

NPI Number : 1609916436
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY A FERNANDEZ LVN
Provider Business Mailing Address
First Line : 3256 PORTER LN
Second Line :
City : VENTURA
State : CA
Zip : 93003-4819
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4129 STATE ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93110-1848
Country : US
Telephone Number : 805-964-4795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY A FERNANDEZ LVN” Practice Location

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