Individual provider Active NPI

Daniel Magalong Fernandez, APCC

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1245959071
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12147 Issued in CA
Practice address
17140 Bernardo Center Dr
San Diego, CA 92128-2093
Phone
(833) 579-4848
NPI assigned
Aug 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12147 CA Primary

Addresses

Primary practice location

17140 Bernardo Center Dr
San Diego, CA 92128-2093

Mailing address

1230 Rockland CT
Chula Vista, CA 91913-1439

Other practice location 1

19000 Homestead Rd Bldg 1
Cupertino, CA 95014-0712
Phone (408) 851-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251119001879 CA Practitioner - Mental Health Counselor 9133574197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

393 E Walnut St 3Rd FL
Pasadena, CA 91188-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17878CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 6, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 6, 2025 Accepting new patients

Locations

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

17140 Bernardo Center Dr
San Diego, CA 92128
Phone (858) 451-5190

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1245959071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 ROCKLAND CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17140 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282093",
            "telephone_number": "833-579-4848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19000 Homestead Rd Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Cupertino",
            "state": "CA",
            "postal_code": "950140712",
            "country_code": "US",
            "telephone_number": "408-851-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DANIEL",
        "middle_name": "MAGALONG",
        "credential": "APCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "12147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.