Individual provider · Type 1 NPI
Marcel Fomotar, CRNP-PMH
Psychiatric/Mental Health Nurse Practitioner · Clovis, CA
NPI number
1447765409
Active
Practice location
1085 Sanders Ave
Clovis, CA 93619-3935
Other practice locations
- 601 E Naylor Mill Rd Unit F, Salisbury, MD 21804-2256 · (410) 572-4738
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 95043929 (CA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R244114 (MD) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95014417 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1447765409
Marcel Fomotar, CRNP-PMH's National Provider Identifier is 1447765409, issued on Dec 12, 2017. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Clovis, CA. The record was last updated on Sep 16, 2022.