Individual provider Active NPI

Marcia M. Fernando, RDHAP

  • Dental Hygienist
  • San Diego, CA
National Provider Identifier
1962654756
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
214 Issued in CA
Practice address
11078 Matinal Cir
San Diego, CA 92127-1260
Phone
(858) 705-0447
Fax
(858) 451-2094
NPI assigned
Oct 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 214 CA Primary

Addresses

Primary practice location

11078 Matinal Cir
San Diego, CA 92127-1260

Mailing address

11078 Matinal Cir
San Diego, CA 92127-1260
Phone (858) 705-0447

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
214CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223856000000",
    "number": "1962654756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11078 MATINAL CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271260",
            "telephone_number": "858-705-0447",
            "fax_number": "858-451-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11078 MATINAL CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271260",
            "telephone_number": "858-705-0447",
            "fax_number": "858-451-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "MARCIA",
        "middle_name": "M.",
        "credential": "RDHAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2008-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.