Individual provider Active NPI

Dana Putnam Fonteneau, M.M., M.A.

  • Mental Health Counselor
  • San Francisco, CA
National Provider Identifier
1528214889
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMF 54561 Issued in CA
Practice address
315 Sanchez St
San Francisco, CA 94114-1615
Phone
(415) 820-1691
NPI assigned
Aug 18, 2008
Last updated
Aug 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMF 54561 CA Primary

Addresses

Primary practice location

315 Sanchez St
San Francisco, CA 94114-1615

Mailing address

776 Grizzly Peak Blvd
Berkeley, CA 94708-1337
Phone (510) 847-3884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMF 54561CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1528214889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 GRIZZLY PEAK BLVD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947081337",
            "telephone_number": "510-847-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SANCHEZ ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141615",
            "telephone_number": "415-820-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENEAU",
        "first_name": "DANA",
        "middle_name": "PUTNAM",
        "name_prefix": "Ms.",
        "credential": "M.M., M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF 54561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.