Individual provider Active NPI

Myra Deanne Fernando, D.O.

  • Child & Adolescent Psychiatry Physician
  • Monterey, CA
National Provider Identifier
1528325883
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
15728 Issued in CA
Practice address
576 Hartnell St Ste 300
Monterey, CA 93940-2887
Phone
(831) 625-4600
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X DO.000467 LA
Child & Adolescent Psychiatry Physician 2084P0804X 15728 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

576 Hartnell St Ste 300
Monterey, CA 93940-2887

Mailing address

616 Sage CT
Pacific Grove, CA 93950-5032
Phone (707) 853-6983

Other identifiers 1

IdentifierTypeStateIssuer
2300393MedicaidLA

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
I20170802002997 CA Practitioner - Psychiatry 0941589360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

576 Hartnell St
Suite 300
Monterey, CA 93940-2887
Phone (831) 625-4600

Hospital & facility affiliations

  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula CurrentSince Aug 1, 2017 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Aug 1, 2017 Accepting new patients

Locations

576 Hartnell St
Ste 300
Monterey, CA 93940
Phone (831) 625-4600

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

576 Hartnell St
Monterey, CA 93940
Phone (831) 625-4600

2 Upper Ragsdale Dr
Bldg B
Monterey, CA 93940
Phone (831) 643-6700

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1528325883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 SAGE CT",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505032",
            "telephone_number": "707-853-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 HARTNELL ST STE 300",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939402887",
            "telephone_number": "831-625-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "MYRA",
        "middle_name": "DEANNE",
        "name_prefix": "Miss",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "LA",
            "license": "DO.000467",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "15728",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2300393",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.