Healthcare Provider Details

I. General information

NPI: 1679464440
Provider Name (Legal Business Name): COLETON SCHMITTO FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 MOWRY AVE STE F
FREMONT CA
94538-1731
US

IV. Provider business mailing address

34969 SKYLARK DR
UNION CITY CA
94587-4669
US

V. Phone/Fax

Practice location:
  • Phone: 510-770-8040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95035565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: