Provider Demographics
NPI:1477839355
Name:FERNANDEZ, ZEYDA MARGARITA (MA)
Entity Type:Individual
Prefix:MS
First Name:ZEYDA
Middle Name:MARGARITA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 N COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2117
Mailing Address - Country:US
Mailing Address - Phone:323-528-5848
Mailing Address - Fax:
Practice Address - Street 1:2550 E FOOTHILL BLVD FL 2
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3406
Practice Address - Country:US
Practice Address - Phone:626-802-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF66381101YM0800X
CAAMFT135023101YM0800X, 106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health