MEDICARE: SUMALI FERNANDO LLC

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	103TC0700X	Clinical Psychologist	1214	OK

General Provider Information

NPI Number	:	1669913117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMALI FERNANDO LLC

Provider Business Mailing Address
First Line	:	3035 NW 63RD ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3632
Country	:	US
Telephone Number	:	405-242-6460
Fax Number	:

Provider Business Practice Location Address
First Line	:	3035 NW 63RD ST
Second Line	:	SUITE 225
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3632
Country	:	US
Telephone Number	:	405-242-6460
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	SUMALI FERNANDO
Credential	:	PSYD
Telephone Number	:	405-242-6460

Provider Enumeration Date	:	03/16/2017
Last Update Date	:	03/09/2026

Similar Medicare Providers

1922075159 — MR. JAMES O HALE MS, LPC, LADC-MH
Practice Location Address:

3035 NW 63RD ST , SUITE 200
OKLAHOMA CITY, OK
73116-3632

Practice Phone: 405-816-7735
Practice Fax: 405-286-1380

1447261755 — DR. KAREN MICHELE DORFMAN PH.D.
Practice Location Address:

3035 NW 63RD ST , SUITE 227
OKLAHOMA CITY, OK
73116-3632

Practice Phone: 405-822-6872
Practice Fax:

1962562033 — MRS. ROSEANNA D. SMITH M.S.
Practice Location Address:

3035 NW 63RD ST , SUITE 151-N
OKLAHOMA CITY, OK
73116-3632

Practice Phone: 405-842-0003
Practice Fax: 405-842-1603

1487710455 — MS. DEBRA D. LUTHER L.P.C.
Practice Location Address:

3035 NW 63RD ST , SUITE 225
OKLAHOMA CITY, OK
73116-3632

Practice Phone: 405-990-1970
Practice Fax: 405-286-3922

1255477634 — DR. C F KIMBERLING JR. PH.D.
Practice Location Address:

3035 NW 63RD ST , STE 1010684
OKLAHOMA CITY, OK
73116-3632

Practice Phone: 405-842-0684
Practice Fax:

1528104957 — MRS. ROSALYNN JEAN ENGLISH M.S.
Practice Location Address:

3035 NW 63RD ST , STE 101
OKLAHOMA CITY, OK
73116-3632

Practice Phone: 405-842-0684
Practice Fax:

Directions to “SUMALI FERNANDO LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.