Provider Demographics
NPI:1811164486
Name:VINUELA, FERNANDO (LMFT)
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:VINUELA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:FERNANDO
Other - Middle Name:
Other - Last Name:VINUELA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA , LMFT
Mailing Address - Street 1:4528 GAVIOTA CT
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2739
Mailing Address - Country:US
Mailing Address - Phone:714-697-4155
Mailing Address - Fax:
Practice Address - Street 1:4528 GAVIOTA CT
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2739
Practice Address - Country:US
Practice Address - Phone:714-697-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF52084106H00000X
CA88215106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist