Fernandez, Divina

Fernandez, Divina is an individual health care provider with primary practice located at 1811 Grand Canal Blvd Ste 2 , Stockton CA 95207-8107. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Fernandez, Divina can be contacted via phone (888) 880-9270.

Contact Information

Primary practice address
1811 Grand Canal Blvd Ste 2 Stockton CA 95207-8107
Phone: (888) 880-9270
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1437584588
LBN Legal business name Fernandez, Divina
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2013
Last updated Jul 9th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437584588 NPPES
California Other 1437584588 NPI

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