Mary Jo Frances Fernandez, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY 9485 Issued in FL

Practice address

1135 NW 23Rd Ave
Suite G
Gainesville, FL 32609-5415

Phone

(781) 710-6539

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1932139425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11307 NW 60TH TER",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326157415",
            "telephone_number": "781-710-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 NW 23RD AVE",
            "address_2": "SUITE G",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326095415",
            "telephone_number": "781-710-6539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MARY JO",
        "middle_name": "FRANCES",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7249",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY 9485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "401761",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W05960",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0501417",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Monique Fernandez, PHARM.D.
• Jacinto Fernandez
• John Fernandez, PA
• Jorge Alberto Fernandez, MD
• Loretta Ellen Fernandez, PHARM.D.
• Melinda Williams Fernandez, MD
• Monica Fernandez, M.S.D
• Priscilla Fernandez, RD
• Samara Fernandez, OD
• Sheria Fernandez

• Counseling Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.