Individual provider Active NPI

Samantha Linda-Selene Fernandez Fernandez, MSN, FNP-C, PHN

  • Family Nurse Practitioner
  • Watsonville, CA
National Provider Identifier
1780255000
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017510 Issued in CA
Practice address
1150 Main St Ste 3
Watsonville, CA 95076-3760
Phone
(831) 728-0551
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017510 CA Primary

Addresses

Primary practice location

1150 Main St Ste 3
Watsonville, CA 95076-3760

Mailing address

1150 Main St Ste 3
Watsonville, CA 95076-3760
Phone (559) 975-9445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241127002158 CA Practitioner - Nurse Practitioner 1951836915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Para la GenteGroup PAC ID 8729984729, 41 clinicians

Practice addresses (Care Compare)

204 E Beach St
Watsonville, CA 95076-4809
Phone (831) 728-8250

Hospital & facility affiliations

  • Watsonville Community Hospital Hospital, Watsonville, CA, CCN 050194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince Feb 3, 2025 Accepting new patients
Plazita Medical Clinic, Inc. Current Accepting new patients
Salud Para la Gente CurrentSince Feb 3, 2025 Accepting new patients
Salud Para la Gente Current Accepting new patients
Plazita Medical Clinic Inc CurrentSince Sep 20, 2024 Accepting new patients

Locations

195 Aviation Way
Ste 200
Watsonville, CA 95076

1150 Main St
Ste 3
Watsonville, CA 95076
Phone (831) 728-0551

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1780255000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 MAIN ST STE 3",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763760",
            "telephone_number": "559-975-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 MAIN ST STE 3",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763760",
            "telephone_number": "831-728-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ FERNANDEZ",
        "first_name": "SAMANTHA",
        "middle_name": "LINDA-SELENE",
        "credential": "MSN, FNP-C, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.