Individual
BEATRIZ FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
641 BROADWAY ST, KING CITY, CA 93930-3231
(831) 521-8101
Mailing address
641 BROADWAY ST, KING CITY, CA 93930-3231
(831) 525-8101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1351300619
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1351300619
CCAPP
CA
Enumeration date
08/01/2019
Last updated
08/01/2019
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