Individual provider Active NPI

Mona Lisa Fernandez, RRT

  • Registered Respiratory Therapist
  • Manteca, CA
National Provider Identifier
1760949093
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
20998 Issued in CA
Practice address
1777 W Yosemite Ave
Manteca, CA 95337-5130
Phone
(209) 825-3700
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 20998 CA Primary

Addresses

Primary practice location

1777 W Yosemite Ave
Manteca, CA 95337-5130

Mailing address

1208 Athens Ave
Modesto, CA 95350-3410
Phone (209) 214-4536

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

State licenses

LicenseStateTypeSpecialty
20998CAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1760949093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 ATHENS AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503410",
            "telephone_number": "209-214-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 W YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375130",
            "telephone_number": "209-825-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MONA",
        "middle_name": "LISA",
        "credential": "RRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "CA",
            "license": "20998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.