Provider Demographics
NPI:1225167166
Name:FERNANDEZ, SARA D (MFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:D
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92878-0194
Mailing Address - Country:US
Mailing Address - Phone:951-907-3710
Mailing Address - Fax:951-734-4920
Practice Address - Street 1:342 BONNIE CIR
Practice Address - Street 2:SUITE A
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-6974
Practice Address - Country:US
Practice Address - Phone:951-907-3710
Practice Address - Fax:951-734-4920
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist