Individual provider Active NPI

Roshinie M Fernando, M.D.

  • Psychiatry Physician
  • Patton, CA
National Provider Identifier
1386959666
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
122145 Issued in CA
Practice address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone
(909) 425-7000
NPI assigned
Aug 11, 2010
Last updated
Mar 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 260861 NY
Psychiatry Physician 2084P0800X 122145 CA Primary

Addresses

Primary practice location

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369

Mailing address

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7000

Other names 1

  • Roshinie Marina Fernando Other name

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140109000024 CA Practitioner - Psychiatry 5991933442 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
122145CAMDMarriage & Family Therapist
260861NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
Central City Community Health Center Inc CurrentSince Jan 1, 2020 Accepting new patients
Central City Community Health Center Inc Current Accepting new patients
Central City Community Health Center Inc CurrentSince Jan 1, 2020 Accepting new patients
County of Riverside CurrentSince Nov 20, 2013 Accepting new patients
County of Riverside CurrentSince Nov 20, 2013 Accepting new patients

Locations

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

1860 Hamner Ave
Norco, CA 92860
Phone (951) 479-0070

1688 N Perris Blvd
Ste L11
Perris, CA 92571
Phone (951) 443-2200

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1386959666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "ROSHINIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "260861",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "122145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSHINIE",
            "last_name": "FERNANDO",
            "middle_name": "MARINA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.