Individual
DR. JONATHAN D FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1207 FAIRCHILD CT, WOODLAND, CA 95695
(530) 668-2600
(530) 669-5695
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A153926
CA
2084P0800X
Psychiatry Physician
ME131118
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2014
Last updated
07/03/2018
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