Individual
MYRNA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
24401 KINGS VW, LAGUNA NIGUEL, CA 92677-7819
(951) 813-1720
Mailing address
24401 KINGS VW, LAGUNA NIGUEL, CA 92677-7819
(951) 813-1720
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT-29396
CA
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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