Provider Demographics
NPI:1447003801
Name:FONTES, COLE (RN)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:FONTES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3768 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2325
Mailing Address - Country:US
Mailing Address - Phone:831-431-3948
Mailing Address - Fax:
Practice Address - Street 1:604 PEARL ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3070
Practice Address - Country:US
Practice Address - Phone:831-649-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95345163163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health