Provider Demographics
NPI:1346778149
Name:MONICA R FERNANDEZ, INC
Entity Type:Organization
Organization Name:MONICA R FERNANDEZ, INC
Other - Org Name:FULLERTON HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:714-871-0632
Mailing Address - Street 1:1480 S HARBOR BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7506
Mailing Address - Country:US
Mailing Address - Phone:714-871-0632
Mailing Address - Fax:714-459-7060
Practice Address - Street 1:1480 S HARBOR BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7506
Practice Address - Country:US
Practice Address - Phone:714-871-0632
Practice Address - Fax:714-459-7060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7009237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376691980OtherHEARING INSTRUMENT SPECIALIST
CA1346778149OtherHEARING INSTRUMENT SPECIALIST
82126352OtherHEARING INSTRUMENTS SPECIALIST