Carleen Mae Gayo Fernandez, CARLEEN FERNANDEZ

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT 8102 Issued in CA

Practice address

11375 Pondhurst Way
Riverside, CA 92505-3471

Phone

(951) 522-1205

NPI assigned

May 15, 2007

Last updated

Jan 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1245446640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11375 PONDHURST WAY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92505",
            "telephone_number": "951-522-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11375 PONDHURST WAY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053471",
            "telephone_number": "951-522-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "CARLEEN MAE",
        "middle_name": "GAYO",
        "name_prefix": "Mrs.",
        "credential": "CARLEEN FERNANDEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 8102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose L. Fernandez Jr., MD
• Emily Fernandez-Bell, FNP-C
• April Marie Fernandez, LCSW
• Benjamin Cesar Villegas Fernandez, LVN
• Carla Veronica Fernandez, RN, BSN
• Chanel J Fernandez
• Deseri Fernandez
• Frances Darlene Fernandez
• Hugo Armando Fernandez Jr., LMFT
• Joshua Fernandez, MD

• Physical Therapy Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.