Kasey Nicole Fontaine, PA-C
Physician Assistant in La Jolla, CA. Individual provider (NPI-1).
NPI number1164044731
StatusActive
Last updated in NPPESAug 5, 2026
Details
- NPI
- 1164044731
- Entity type
- Individual (NPI-1)
- Name
- Kasey Nicole Fontaine
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2020
- Certification date
- Aug 5, 2026
- Last updated
- Aug 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA61270555 | WA | Yes |
Practice location
9850 Genesee Ave Ste 820La Jolla, CA 92037-1219
Phone 858-677-0777
Mailing address
9850 Genesee Ave Ste 820La Jolla, CA 92037-1219
Phone 858-677-0777
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