Provider Demographics
NPI:1316062896
Name:FERNANDEZ, PATRICIA EMELINA (PSYD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:EMELINA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-0112
Mailing Address - Country:US
Mailing Address - Phone:888-316-1038
Mailing Address - Fax:888-316-1928
Practice Address - Street 1:1705 S KAHUNA DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-1029
Practice Address - Country:US
Practice Address - Phone:888-316-1038
Practice Address - Fax:888-316-1928
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2006153103TC0700X
WA60074786103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical