Provider Demographics
NPI:1447843693
Name:FONTANILLA, FRANCES MAUREEN PAREL
Entity type:Individual
Prefix:
First Name:FRANCES MAUREEN
Middle Name:PAREL
Last Name:FONTANILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 PARK ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:CA
Mailing Address - Zip Code:95437-4410
Mailing Address - Country:US
Mailing Address - Phone:707-972-3925
Mailing Address - Fax:
Practice Address - Street 1:776 S STATE ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5847
Practice Address - Country:US
Practice Address - Phone:707-463-4915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health