Individual
REGINA FERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
233 ORANGEFAIR MALL, FULLERTON, CA 92832-3038
(714) 970-6116
Mailing address
233 ORANGEFAIR MALL, FULLERTON, CA 92832-3038
(714) 970-6116
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
24940
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018037190
MO OT LICENSE
MO
01
—
OT24940
CA OT LICENSE
CA
Enumeration date
05/22/2023
Last updated
04/10/2026
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