Individual provider Active NPI

Wilda M Fernandez, MSW

  • Clinical Social Worker
  • Cabo Rojo, PR
National Provider Identifier
1538248406
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6749 Issued in PR
Practice address
Brau 46B St.
Suite 1
Cabo Rojo, PR 00623-0684
Phone
(787) 613-5719
NPI assigned
Nov 3, 2006
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6749 PR Primary

Addresses

Primary practice location

Brau 46B St.
Suite 1
Cabo Rojo, PR 00623-0684

Mailing address

PO Box 1311
Boqueron, PR 00622-1311
Phone (787) 851-6016

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6749PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1538248406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1311",
            "city": "BOQUERON",
            "state": "PR",
            "postal_code": "006221311",
            "telephone_number": "787-851-6016",
            "fax_number": "787-851-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRAU 46B ST.",
            "address_2": "SUITE 1",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "006230684",
            "telephone_number": "787-613-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "WILDA",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "6749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabo Rojo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.