Provider Demographics
NPI:1841903515
Name:FERNANDEZ, ASHLEY A
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:FERNANDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 WOODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1443
Mailing Address - Country:US
Mailing Address - Phone:732-757-8469
Mailing Address - Fax:
Practice Address - Street 1:5120 WOODLEY AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1443
Practice Address - Country:US
Practice Address - Phone:732-757-8469
Practice Address - Fax:888-385-7037
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406339363LP0808X
NJ26NJ01414200363LP0808X
CANP95032130363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95032130OtherCA PMHNP
NJ26NJ01414200OtherNJ PMHNP
NY406339OtherPSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER NY LICENSE