Carla Fernandez

Key facts

NPI

1164093555

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

709 Brookside PL
Colwich, KS 67030-9683

Phone

(131) 636-4876

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 7, 2021.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1164093555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 BROOKSIDE PL",
            "city": "COLWICH",
            "state": "KS",
            "postal_code": "670309683",
            "telephone_number": "131-636-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 BROOKSIDE PL",
            "city": "COLWICH",
            "state": "KS",
            "postal_code": "670309683",
            "telephone_number": "131-636-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "CARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colwich, KS

• Tawanisha Dean
• Veronica Deloera
• Cahlea Drescher
• Katherine Ehrlich
• Meka Espinoza
• Elizabeth Fernandez
• Ariel Fluharty
• Tarika Forman
• Kallee Forslund
• Miranda Fritz

All providers in Colwich, KS · Behavior Technician in Kansas