Individual
MR. FERNANDO DE ANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 FREEDOM BLVD STE F, WATSONVILLE, CA 95076-2752
(831) 763-8200
Mailing address
1430 FREEDOM BLVD STE F, WATSONVILLE, CA 95076-2752
(831) 763-8200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
372600000X
Adult Companion
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A6489688
D.L
CA
Enumeration date
06/13/2007
Last updated
05/06/2026
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