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Organization
NINETTE FONSECA-CHICCA MS SPEECH AND LANGUAGE PATHOLOGIST-CCC A PROFES
Active
Organization
NINETTE FONSECA-CHICCA MS SPEECH AND LANGUAGE PATHOLOGIST-CCC A PROFES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NINETTE FONSECA CHICCA MS, CCC-SLP (PRESIDENT/SPEECH PATHOLOGIST)
(707) 364-6075
Entity
Organization
Contact information
Practice address
1295 PETALUMA BLVD N STE 5, PETALUMA, CA 94952-6530
(707) 364-6075
(707) 795-5709
Mailing address
2430 SONOMA MOUNTAIN RD, PETALUMA, CA 94954-9283
(707) 364-6075
(707) 795-5709
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP17198
CA
Other
Enumeration date
09/23/2009
Last updated
12/21/2011
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