Andrew Lazaro Fonticiella, PA STUDENT is a
Student In An Organized Health Care Education/training Program based in San Lorenzo, California. Andrew Lazaro Fonticiella is licensed to practice in California (license number ) and his current practice location is
16037 Via Del Sol, San Lorenzo, California. He can be reached at his office (for appointments etc.) via phone at
(818) 935-7076.
NPI number for Andrew Lazaro Fonticiella is 1023814001 and his current mailing address is 16037 Via Del Sol, San Lorenzo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023814001.
Provider's Profile
| Full Name | Andrew Lazaro Fonticiella |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 16037 Via Del Sol, San Lorenzo, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1023814001
- Provider Enumeration Date: 02/20/2025
- Last Update Date: 02/20/2025
Medical Identifiers
Medical identifiers for Andrew Lazaro Fonticiella such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023814001 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | STUDENT (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andrew Lazaro Fonticiella is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Andrew Lazaro Fonticiella, PA STUDENT
16037 Via Del Sol,
San Lorenzo, CA 94580-2407
Ph: (818) 935-7076 | Andrew Lazaro Fonticiella, PA STUDENT
16037 Via Del Sol,
San Lorenzo, CA 94580-2407
Ph: (818) 935-7076 |
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