Provider Demographics
NPI:1275401960
Name:FONTANOT, VICTORIA (NP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FONTANOT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 REDWOOD DR STE 16
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-3054
Mailing Address - Country:US
Mailing Address - Phone:707-664-5334
Mailing Address - Fax:
Practice Address - Street 1:7950 REDWOOD DR STE 16
Practice Address - Street 2:
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-3054
Practice Address - Country:US
Practice Address - Phone:707-664-5334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-25
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA950193742083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine