Provider Demographics
NPI:1447501549
Name:FOSTER, ALEA (FNP)
Entity type:Individual
Prefix:
First Name:ALEA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10601 CHURCH ST
Mailing Address - Street 2:#105
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6863
Mailing Address - Country:US
Mailing Address - Phone:909-989-7100
Mailing Address - Fax:909-989-7100
Practice Address - Street 1:10601 CHURCH ST
Practice Address - Street 2:#105
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6863
Practice Address - Country:US
Practice Address - Phone:909-989-7100
Practice Address - Fax:909-989-7100
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily