Amber Fonteyne, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

19268 Issued in CA

Practice address

340 Main St # 140a
Venice, CA 90291-2524

Phone

(310) 310-6380

NPI assigned

Nov 22, 2013

Last updated

Jun 5, 2014By the provider in NPPES

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

• Amber Lyn Brothers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1790115012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAIN ST # 140A",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912524",
            "telephone_number": "310-310-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAIN ST # 140A",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912524",
            "telephone_number": "310-310-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTEYNE",
        "first_name": "AMBER",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "19268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "BROTHERS",
            "middle_name": "LYN",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dawn Kuleana Freitas, CMT, CPMT, LMT, NMT

• Adult Health Nurse Practitioner in Venice, CA
• Providers in Venice, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.