Active NPI
Diana Fernandez, M.S.
- Marriage & Family Therapist
- Lake Elsinore, CA
National Provider Identifier
1467868034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF75903
- Practice address
- 31946 Mission TRL
Suite B
Lake Elsinore, CA 92530-4539 - Phone
- (951) 245-7663
- NPI assigned
- Jul 3, 2014
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF75903 | CA | Primary |
Addresses
Primary practice location
31946 Mission TRL
Suite B
Lake Elsinore, CA 92530-4539
Mailing address
31946 Mission TRL
Suite B
Lake Elsinore, CA 92530-4539
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF75903 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404345600000",
"number": "1467868034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31946 MISSION TRL",
"address_2": "SUITE B",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31946 MISSION TRL",
"address_2": "SUITE B",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304539",
"telephone_number": "951-245-7663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "DIANA",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-03",
"last_updated": "2014-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF75903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.