Nicholas Fortunato

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131002624 Issued in VA

Practice address

1354 47TH Ave
San Francisco, CA 94122-1115

Phone

(360) 628-2302

NPI assigned

Apr 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1609261833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236071821",
            "telephone_number": "480-571-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 47TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941221115",
            "telephone_number": "360-628-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNATO",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA2947",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131002624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maurice Forte
• Laronda Fortenberry
• Shirley Forteza
• Derek Fortier
• Floyd D Fortuin, MD
• John Foss
• Anne Christina Fossella, MA, MFT
• Audrey E. Foster-Barber, M.D.
• April Foster
• Benica Jane Foster, LCSW

• Occupational Therapy Assistant in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.