Jessica Lynne Fonte, LAC
Individual provider Active NPI Counselor · Alpine, CA
NPI 1295915064 · NPPES record last updated May 27, 2016
Key facts
- NPI
- 1295915064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- LPCC2888 (CA)
- Practice address
- 2120 Alpine Blvd.
Alpine Special Treatment Center
Alpine, CA 91901 - Phone
- (619) 659-3120
- Fax
- (619) 445-0444
- NPI assigned
- Nov 9, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC2888 | CA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Counselor | 101Y00000X | LPCC2888 | CA | Yes |
Addresses
Primary practice location
2120 Alpine Blvd.
Alpine Special Treatment Center
Alpine, CA 91901
Mailing address
2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020
Other providers in Alpine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.