Angelica Maria Fernandez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

75172 Issued in CA

Practice address

1126 N Grand Ave Ste D
Covina, CA 91724-1552

Phone

(626) 967-1667

NPI assigned

Aug 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Angelica Maria Palacios Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Irwindale, CA
  • NPI 1821495003
  NPD (past)

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1750697231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 N GRAND AVE STE D",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241552",
            "telephone_number": "626-967-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N GRAND AVE STE D",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241552",
            "telephone_number": "626-967-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ANGELICA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "PALACIOS",
            "middle_name": "MARIA",
            "credential": "MSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rodolfo Felix
• Tiffany Michelle Felix
• Justin Fenton
• Lorie Dian Ferguson
• Fermina V. Bebing, DDS Inc.
• Brenda Fernandez
• Cielo Divine Fernandez
• Kiara Fernandez
• Lidia Fernandez
• Reynaldo Dela Rosa Fernandez

• Clinical Social Worker in Covina, CA
• Providers in Covina, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.