Provider Demographics
NPI:1639885775
Name:FERNANDEZ, BARBARA YAHEILY
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:YAHEILY
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 HAWKINS ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4539
Mailing Address - Country:US
Mailing Address - Phone:575-202-1117
Mailing Address - Fax:
Practice Address - Street 1:3876 HAWKINS ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4539
Practice Address - Country:US
Practice Address - Phone:575-202-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician