Fernando Octavio De Alba
Counselor, Mental Health in Stockton, CA. Individual provider (NPI-1).
NPI number1962068841
StatusActive
Last updated in NPPESFeb 23, 2021
Details
- NPI
- 1962068841
- Entity type
- Individual (NPI-1)
- Name
- Fernando Octavio De Alba
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 15, 2019
- Certification date
- Feb 23, 2021
- Last updated
- Feb 23, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
1212 N California StStockton, CA 95202-1552
Phone 209-468-8686
Mailing address
2495 W March LnStockton, CA 95207-8251
Phone 209-465-1080 · Fax 209-465-2709
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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