Individual
TAMMY FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
341 N KAWEAH AVE, EXETER, CA 93221-1221
(760) 920-5761
(866) 468-0578
Mailing address
17828 AVENUE 184, STRATHMORE, CA 93267-9520
(760) 920-5761
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
79563
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79563
MASSAGE THERAPIST
CA
Enumeration date
10/07/2019
Last updated
05/14/2022
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