Healthcare Provider Details

I. General information

NPI: 1689164733
Provider Name (Legal Business Name): GENEVIEVE ANN FONSECA DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GENEVIEVE ANN TALAMANTEZ

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N SAN SABA STE 960
SAN ANTONIO TX
78207-3100
US

IV. Provider business mailing address

315 N SAN SABA STE 960
SAN ANTONIO TX
78207-3100
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-2707
  • Fax:
Mailing address:
  • Phone: 210-704-2707
  • Fax: 210-472-0255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP136995
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP136995
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: