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Individual
LUIS FERNANDEZ
Active
Individual
LUIS FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006
—
CA
Enumeration date
04/25/2007
Last updated
07/21/2022
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