Fernandez, Larry

Fernandez, Larry is an individual health care provider with primary practice located at 108 W Victoria St , Gardena CA 90248-3523. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fernandez, Larry can be contacted via phone (310) 715-2020.

Contact Information

Primary practice address
108 W Victoria St Gardena CA 90248-3523
Phone: (310) 715-2020
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 29009 California

Profile Details

NPI number 1396860938
LBN Legal business name Fernandez, Larry
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Oct 24th, 2023 - about last year

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 1396860938 NPPES
California MEDICAID 1396860938

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