Provider Demographics
NPI:1881359990
Name:FERNANDES, CHRISTOPHER (AMFT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:FERNANDES
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 MORRO RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4429
Mailing Address - Country:US
Mailing Address - Phone:805-610-0334
Mailing Address - Fax:
Practice Address - Street 1:7362 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4429
Practice Address - Country:US
Practice Address - Phone:805-610-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist