Individual
MR. CARLOS FONSECA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 MAIN ST, KLAMATH FALLS, OR 97601-5810
(541) 238-2289
Mailing address
341 NE POMONA ST APT 106, ROSEBURG, OR 97470-8053
(541) 827-9436
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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