Individual
SUSAN BRENDA FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1370 S STATE ST STE A, SAN JACINTO, CA 92583-4922
(951) 791-3350
Mailing address
1370 S STATE ST STE A, SAN JACINTO, CA 92583-4922
(951) 791-3350
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
07/23/2026
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