Active NPI
Monica Fernandez, PA-C
- Physician Assistant
- Glendale, AZ
National Provider Identifier
1962688424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3717
- Practice address
- 17218 N 72ND Dr
Suite 100
Glendale, AZ 85308-8580 - Phone
- (623) 334-8670
- NPI assigned
- Jan 15, 2008
- Last updated
- Jan 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3717 | AZ | Primary |
Addresses
Primary practice location
17218 N 72ND Dr
Suite 100
Glendale, AZ 85308-8580
Mailing address
6233 West Behrend Dr.
Apt 2046
Glendale, AZ 85308
Phone (623) 363-9945
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1962688424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6233 WEST BEHREND DR.",
"address_2": "APT 2046",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "623-363-9945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17218 N 72ND DR",
"address_2": "SUITE 100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088580",
"telephone_number": "623-334-8670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MONICA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-15",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "3717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.