Andrew Lazaro Fonticiella, PA STUDENT is a medicare enrolled "Student In An Organized Health Care Education/training Program" in San Lorenzo, California. He graduated from nursing school in 2025 and has 1 years of diverse experience with area of expertise as Physician Assistant. His current practice location is
16037 Via Del Sol, San Lorenzo, California. You can reach out to his office (for appointments etc.) via phone at
(818) 935-7076.
Andrew Lazaro Fonticiella is licensed to practice in California (license number ) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1023814001.
Provider's Profile
| Full Name | Andrew Lazaro Fonticiella |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
|---|
| Experience | 1 Years |
|---|
| Location | 16037 Via Del Sol, San Lorenzo, California |
|---|
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Andrew Lazaro Fonticiella graduated from nursing school in 2025
NPI Data:
- NPI Number: 1023814001
- Provider Enumeration Date: 02/20/2025
- Last Update Date: 04/10/2026
Medicare PECOS Information:
- PECOS PAC ID: 5991272171
- Enrollment ID: I20260424001342
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 | PA67745 (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
enrolled with medicare and thus, if eligible, can 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 |
Reviews and Comments