Individual
CHRISTINA FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-9713
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6400
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/10/2015
Last updated
05/30/2026
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