Individual
STEFANIE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4839
Mailing address
229 SAN LUIS PARKWAY, AVILA BEACH, CA 93424
(805) 748-8069
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
30302
CA
Other
Enumeration date
12/12/2013
Last updated
05/22/2019
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