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Contact Information

JENNIFER A FOUNTAIN, PA-C
101 WEST COAST ROAD #B
REDWAY, CA95560
 Phone: 707-923-2783
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JENNIFER A FOUNTAIN · (Female)

NPI Number 1427836576
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/19/2023
Last updated 10/08/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CA License # PA64783
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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