# GLENN FORD FERNANDO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1912377441
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | 286155 | CA | Yes |

## Other

- **Enumeration date:** 09/26/2015
- **Last updated:** 09/26/2015