Active NPI
Luis Fernandez
- Behavior Analyst
- Garden Grove, CA
National Provider Identifier
1700344900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 12395 Lewis St Ste 202
Garden Grove, CA 92840-4694 - Phone
- (714) 867-6384
- NPI assigned
- Mar 6, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
12395 Lewis St Ste 202
Garden Grove, CA 92840-4694
Mailing address
7010 Estrella Ave Apt 3
Los Angeles, CA 90044-6257
Phone (323) 527-4501
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1700344900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7010 ESTRELLA AVE APT 3",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900446257",
"telephone_number": "323-527-4501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12395 LEWIS ST STE 202",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928404694",
"telephone_number": "714-867-6384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "LUIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-06",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.