Provider Demographics
NPI:1184794844
Name:OCEGUEDA, FERNADINA (MHRS, CAS)
Entity type:Individual
Prefix:
First Name:FERNADINA
Middle Name:
Last Name:OCEGUEDA
Suffix:
Gender:F
Credentials:MHRS, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 BROADWAY
Mailing Address - Street 2:STE 206
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2767
Mailing Address - Country:US
Mailing Address - Phone:619-426-4872
Mailing Address - Fax:619-420-8056
Practice Address - Street 1:1105 BROADWAY
Practice Address - Street 2:STE 206
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2767
Practice Address - Country:US
Practice Address - Phone:619-426-4872
Practice Address - Fax:619-420-8056
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator