Healthcare Provider Details

I. General information

NPI: 1932003134
Provider Name (Legal Business Name): ANTHONY D FOX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4241 CARLSON WAY # 1011
DIAMOND SPRINGS CA
95619-9200
US

IV. Provider business mailing address

965 WILSON BLVD
EL DORADO HILLS CA
95762-7251
US

V. Phone/Fax

Practice location:
  • Phone: 530-888-0000
  • Fax:
Mailing address:
  • Phone: 530-457-7789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: