Therese Mariel Fonseca, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95032530 Issued in CA

Practice address

43322 Gingham Ave
Lancaster, CA 93535-4576

Phone

(661) 874-4050

NPI assigned

Nov 4, 2024

Sex

Female

Sole proprietor

Yes

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

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

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bartz-Altadonna Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1811279763
  Medicare reassignment NPD
• Bartz-Altadonna Community Health Center

  • Community/Retail Pharmacy
  • Lancaster, CA
  • NPI 1700672011
  NPD

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1902629348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40301 PRESTON RD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43322 GINGHAM AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354576",
            "telephone_number": "661-874-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "THERESE",
        "middle_name": "MARIEL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95185009",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pascualita Flores
• Randy Amir Flores
• Stephanie Flores
• Scott Flowers
• Vincent Edward Foley
• Nanette Chua Fonte, M.D.
• Elizabeth Fontenette
• Rose Forde
• Teresa Fordham-Jacobs
• Fort Medical Supplies, Inc.

• Family Nurse Practitioner in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.