Provider Demographics
NPI:1770142663
Name:FERNANDEZ SANCHEZ, ANDREA CAROLINA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CAROLINA
Last Name:FERNANDEZ SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2783 BETTIS AVE
Mailing Address - Street 2:
Mailing Address - City:WASCO
Mailing Address - State:CA
Mailing Address - Zip Code:93280-2922
Mailing Address - Country:US
Mailing Address - Phone:661-520-2518
Mailing Address - Fax:
Practice Address - Street 1:2783 BETTIS AVE
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-2922
Practice Address - Country:US
Practice Address - Phone:661-910-6673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145323106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist