Provider Demographics
NPI:1265610414
Name:FERNANDEZ, STEVE (BS)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4561 HALIFAX RD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-1519
Mailing Address - Country:US
Mailing Address - Phone:626-409-3750
Mailing Address - Fax:
Practice Address - Street 1:11001 VALLEY MALL
Practice Address - Street 2:300
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2620
Practice Address - Country:US
Practice Address - Phone:626-442-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator