Provider Demographics
NPI:1063449155
Name:FERNANDEZ, ROWENA C (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROWENA
Middle Name:C
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CALLE ESPOLON
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2302
Mailing Address - Country:US
Mailing Address - Phone:949-241-4830
Mailing Address - Fax:
Practice Address - Street 1:26440 LA ALAMEDA
Practice Address - Street 2:STE. 380
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6304
Practice Address - Country:US
Practice Address - Phone:949-241-4830
Practice Address - Fax:949-582-3002
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS168401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical