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General NPI Number Information
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NPI Number | 1861710675
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Entity Type | Individual
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Provider Name | DAVID LAWRENCE FONTES PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 8841 WILLIAMSON DR SUITE 40
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City | ELK GROVE
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State | CA
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Zip | 95624-1800
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Country | US
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Telephone | 916-685-5258
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Fax | 916-653-0782
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Provider Business Mailing Address
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Address Line | 8841 WILLIAMSON DR SUITE 40
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City | ELK GROVE
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State | CA
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Zip | 95624-1800
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Country | US
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Telephone | 916-685-5258
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Fax | 916-653-0782
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY#18439
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License Number State | CA
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