Individual
MRS. CARLEEN MAE GAYO FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CARLEEN FERNANDEZ
Contact information
Practice address
11375 PONDHURST WAY, RIVERSIDE, CA 92505-3471
(951) 522-1205
Mailing address
11375 PONDHURST WAY, RIVERSIDE, CA 92505
(951) 522-1205
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 8102
CA
Other
Enumeration date
05/15/2007
Last updated
01/09/2015
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