Christina Lynn Fantozzi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

21745 Issued in CA

Practice address

6511 Coyle Ave
2ND Floor
Carmichael, CA 95608-0306

Phone

(916) 536-3665

Fax

(916) 536-3593

NPI assigned

Oct 13, 2011

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

• Tina Fantozzi Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: cfantozzi316921@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1699050385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6511 COYLE AVE",
            "address_2": "2ND FLOOR",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080306",
            "telephone_number": "916-536-3665",
            "fax_number": "916-536-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTOZZI",
        "first_name": "CHRISTINA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "FANTOZZI",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fair Oaks Estates
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• Cynthia L. Fairman, RD CDE
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• Howard J Fan, M.D.
• Jamshid Faraji, M.D.
• Mehrnoush Fathi, MD
• Alina Fatima, MD
• Mallory Fawns
• Abdul Qasem Fazely

• Physician Assistant in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.