Provider Demographics
NPI:1386959203
Name:ARMENDARIZ, FERNANDO REBLING (PHD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:REBLING
Last Name:ARMENDARIZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 N PONTATOC RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6759
Mailing Address - Country:US
Mailing Address - Phone:520-795-2680
Mailing Address - Fax:520-743-2003
Practice Address - Street 1:3900 N PONTATOC RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6759
Practice Address - Country:US
Practice Address - Phone:520-795-2680
Practice Address - Fax:520-743-2003
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4103103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities