Christina Daria Fonseca, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A101459 Issued in CA

Practice address

320 Lennon Lane Kaiser Permanente Medical Group
Department of Dermatology
Walnut Creek, CA 94598

Phone

(925) 617-5600

Fax

(916) 442-5702

NPI assigned

Sep 4, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Christina Darla Mumm Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Oklahoma College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Dermatology

  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Dermatology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1225222128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 LENNON LANE KAISER PERMANENTE MEDICAL GROUP",
            "address_2": "DEPARTMENT OF DERMATOLOGY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-817-5600",
            "fax_number": "916-442-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LENNON LANE KAISER PERMANENTE MEDICAL GROUP",
            "address_2": "DEPARTMENT OF DERMATOLOGY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-617-5600",
            "fax_number": "916-442-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "CHRISTINA",
        "middle_name": "DARIA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A101459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "320 Lennon Ln",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945982419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "MUMM",
            "middle_name": "DARLA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katherine J. Fong, MD
• Nicholas Fong, DO
• Patricia Katherine Fong, DPT
• Susan K Fong, PHARM-D
• Whallen Fong, R.PH
• Rebecca Fontaine, LCSW
• Andrew Fontan
• For Your Eyes Only Ophthalmic Medical Corp.
• Danielle Cheri Ford
• Niki Forghani, OD

• Dermatology Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.