Active NPI
Divina Fernandez
- Behavior Technician
- Elk Grove, CA
National Provider Identifier
1437584588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8872 Stratham Way
Elk Grove, CA 95758-1323 - Phone
- (209) 423-0388
- NPI assigned
- Sep 9, 2013
- Last updated
- Sep 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
8872 Stratham Way
Elk Grove, CA 95758-1323
Mailing address
1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emq Families First | Past | Accepting new patients |
Organizations & group practices 1
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": "1378684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1437584588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 GRAND CANAL BLVD STE 2",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952078107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8872 STRATHAM WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957581323",
"telephone_number": "209-423-0388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "DIVINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-09",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.