Laura Fernandez, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9982 Issued in FL

Practice address

3 Shircliff Way Ste 601
Jacksonville, FL 32204-4776

Phone

(786) 413-0336

NPI assigned

Sep 28, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mindful Freedom Psychological Services Corp

  • Clinical Psychologist
  • Jacksonville, FL
  • NPI 1225745425
  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659880060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044776",
            "telephone_number": "786-413-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044776",
            "telephone_number": "786-413-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Eduardo Fernandez
• Gabriellea Elizabeth Zito Fernandez
• Giannia Fernandez
• Jessica Fernandez, BCBA
• Kristin P. Fernandez, D.O.
• Maria Taldi Fernandez, APRN
• Nicole Fernandez, OTD, OTR/L
• Obed Fernandez
• Peter Fernandez, CRNA
• Rosemarie Fernandez, M.D.

• Clinical Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.