Fernandez, Vivian
Fernandez, Vivian is an sole proprietor health care provider with primary practice located at 9340 W Stockton Blvd , Elk Grove CA 95758-8014. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Fernandez, Vivian can be contacted via phone (916) 683-5732.Contact Information
Primary practice address
9340 W Stockton Blvd
Elk Grove CA 95758-8014
Phone: (916) 683-5732
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 54142 | California |
Profile Details
| NPI number | 1124165261 |
|---|---|
| LBN Legal business name | Fernandez, Vivian |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2007 |
| Last updated | Jun 20th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124165261 | NPPES |
| California | MEDICAID | D54142 |
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