Individual
NICHOLAS FORTUNATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1354 47TH AVE, SAN FRANCISCO, CA 94122-1115
(360) 628-2302
Mailing address
6915 WARWICK BLVD, NEWPORT NEWS, VA 23607-1821
(480) 571-1278
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002624
VA
224Z00000X
Occupational Therapy Assistant
OTA2947
CA
Other
Enumeration date
04/03/2015
Last updated
03/16/2023
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