Individual
CHANTAL VERONIQUE FORFOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 4TH ST STE 795, SAN RAFAEL, CA 94901-3120
(415) 922-9122
(415) 920-9925
Mailing address
1000 4TH ST STE 795, SAN RAFAEL, CA 94901-3120
(415) 922-9122
(415) 920-9925
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A119000
CA
Other
Enumeration date
06/30/2010
Last updated
01/09/2026
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