Basic Information
| Provider Information | |||||||||
| NPI: | 1477222081 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERNANDEZ | ||||||||
| FirstName: | BRIANA | ||||||||
| MiddleName: | BIANCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1510 TULARE ST | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933053668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613794331 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1401 L ST | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933014522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618686100 | ||||||||
| FaxNumber: | 6618680841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2021 | ||||||||
| LastUpdateDate: | 11/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 11304 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.