Provider Demographics
NPI:1083838999
Name:FERNANDEZ, RANJINI F (PT)
Entity Type:Individual
Prefix:
First Name:RANJINI
Middle Name:F
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RANJINI
Other - Middle Name:F
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2255 CAHUILLA ST
Mailing Address - Street 2:#142
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-4718
Mailing Address - Country:US
Mailing Address - Phone:909-427-4075
Mailing Address - Fax:
Practice Address - Street 1:9961 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 285952251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology