Fong, Marcella

Fong, Marcella is an individual health care provider with primary practice located at 2545 W Hammer Ln , Stockton CA 95209-2839. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Fong, Marcella can be contacted via phone (209) 957-7050.

Contact Information

Primary practice address
2545 W Hammer Ln Stockton CA 95209-2839
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 244783 California
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1033 California

Profile Details

NPI number 1518923937
LBN Legal business name Fong, Marcella
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Jun 14th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518923937 NPPES
California MEDICAID RN3300814

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