Provider Demographics
NPI:1326232455
Name:FONTANA, SONJA IRENE (DNP, FNP)
Entity Type:Individual
Prefix:MS
First Name:SONJA
Middle Name:IRENE
Last Name:FONTANA
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N. DEMAREE ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5156
Mailing Address - Country:US
Mailing Address - Phone:559-734-6700
Mailing Address - Fax:559-734-6705
Practice Address - Street 1:1011 N. DEMAREE ST.
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5156
Practice Address - Country:US
Practice Address - Phone:559-734-6700
Practice Address - Fax:559-734-6705
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA450325163WG0000X, 364SF0001X
CA11610207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP0856899OtherDEA
CJ088ZMedicare PIN