Healthcare Provider Details

I. General information

NPI: 1427655463
Provider Name (Legal Business Name): PARIA FANTINI ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 10TH ST STE 201
CORONADO CA
92118-3420
US

IV. Provider business mailing address

4322 APPLETON ST
SAN DIEGO CA
92117-1905
US

V. Phone/Fax

Practice location:
  • Phone: 619-614-7439
  • Fax:
Mailing address:
  • Phone: 571-205-8696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: