Individual
MRS. TERRELYN C FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1620 PENNSYLVANIA AVE STE C, FAIRFIELD, CA 94533-3509
(707) 428-4878
Mailing address
1620 PENNSYLVANIA AVE STE C, FAIRFIELD, CA 94533-3509
(707) 428-4878
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA13073
STATE LICENSE NUMBER
CA
Enumeration date
03/15/2007
Last updated
07/08/2007
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