Individual provider Active NPI

Amy Jo Fernandez, RN

  • Registered Nurse
  • Chula Vista, CA
National Provider Identifier
1780124099
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95087644 Issued in CA
Practice address
1295 Broadway
Suite 201
Chula Vista, CA 91911-2982
Phone
(888) 743-7526
Fax
(619) 291-0959
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95087644 CA Primary

Addresses

Primary practice location

1295 Broadway
Suite 201
Chula Vista, CA 91911-2982

Mailing address

1075 Camino del Rio S
San Diego, CA 92108-3538
Phone (619) 881-4500

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95087644CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1780124099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 CAMINO DEL RIO S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083538",
            "telephone_number": "619-881-4500",
            "fax_number": "619-291-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 BROADWAY",
            "address_2": "SUITE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112982",
            "telephone_number": "888-743-7526",
            "fax_number": "619-291-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95087644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.