Provider Demographics
NPI:1235236936
Name:FERNANDEZ, MANUEL LIM (CNA)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:LIM
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-2013
Mailing Address - Country:US
Mailing Address - Phone:714-731-5530
Mailing Address - Fax:
Practice Address - Street 1:1411 HARMONY LN
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-2013
Practice Address - Country:US
Practice Address - Phone:714-731-5530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health