Individual
ANITA FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
133 FOURTH STREET, GONZALES, CA 93926
(831) 675-3601
(831) 675-3966
Mailing address
PO BOX 646, 133 FOURTH STREET, GONZALES, CA 93926-0646
(831) 675-3601
(831) 675-3966
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13040
CA
Other
Enumeration date
06/08/2009
Last updated
01/13/2014
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