CHANTAL VERONIQUE FORFOTA (NPI# 1932410388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932410388 |
| Entity Type | Individual |
| Full Name | CHANTAL VERONIQUE FORFOTA |
| Credential | M.D. |
| Practice Address |
222 W 39th Ave San Mateo CA 94403-4364 |
| Practice Telephone | 6505732530 |
| Practice Fax Number | 6505732527 |
| Mailing Telephone | 6505732530 |
| Mailing Fax Number | 6505732527 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
222 W 39TH AVE |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94403-4364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683789 | Diana V Jao | Internal Medicine | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2005-07-20 |
| 1306465125 | Rennie Burke | Student in an Organized Health Care Education/Training Program | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-04-11 |
| 1447887856 | Michelle Wong | Physical Therapist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-03-25 |
| 1508406398 | Alexandria Vanessa Perez | Counselor | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-01-09 |
| 1275197899 | Connie Chen | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2019-04-29 |
| 1063075596 | Jiaochen Ke | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2019-04-19 |
| 1952877524 | Asmi Mehta | Physical Therapist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-10-22 |
| 1649753427 | Ariane Beck | Emergency Medicine | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-09-08 |
| 1114408176 | Matthew Tyler Sachs | Registered Nurse | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-08-27 |
| 1679066047 | Niloofar Zabihi | Pharmacist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520903 | Happy Enerqi LLC | Acupuncturist | 5 43rd Ave, San Mateo, CA 94403 | 2019-10-21 |
| 1740840396 | Vincent Wing Ching Fong | Marriage & Family Therapist | 2600 S. El Camino Real Suite 200, San Mateo, CA 94403 | 2019-06-17 |
| 1861056426 | Denise Gaytan | Licensed Vocational Nurse | 2600 El Camino, San Mateo, CA 94403 | 2019-04-29 |
| 1134686991 | Connie Markoff | Counselor | 3827 Fernwood St, San Mateo, CA 94403 | 2019-02-27 |
| 1467965392 | Happyqi Inc | Acupuncturist | 5 43rd Ave., San Mateo, CA 94403 | 2017-11-14 |
| 1710403092 | John Luu | Chiropractor | 3153 Campus Dr, San Mateo, CA 94403 | 2017-08-17 |
| 1477009033 | Latifunisa Lilani | Community Health Worker | 2600 El Camino Real, San Mateo, CA 94403 | 2016-09-01 |
| 1881029874 | Juan Carlos Friesen | Licensed Vocational Nurse | 2600 S. El Camino, Suite #200, San Mateo, CA 94403 | 2013-09-09 |
| 1619300423 | Emily Rodda | Nurse Practitioner | 222 W. 39th Avenue, San Mateo Medical Center - Pediatric Clinic, San Mateo, CA 94403 | 2013-08-15 |
| 1619309549 | Maria Lucila Echeverria-bustios | Counselor | 1911 Ivy St., San Mateo, CA 94403 | 2013-08-02 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376033084 | William Chan | Student in an Organized Health Care Education/Training Program | 225 37th Ave # 3f, San Mateo, CA 94403-4324 | 2018-05-17 |
| 1467991778 | Maria Elena Lopez | Student in an Organized Health Care Education/Training Program | 325 Villa Terrace, San Mateo, CA 94401 | 2017-02-20 |
| 1407230667 | Kimberly M Gray | Student in an Organized Health Care Education/Training Program | 225 37th Ave Fl 3rf, San Mateo, CA 94403-4324 | 2015-07-16 |
| 1720492135 | Alison Alana Parker-cole | Student in an Organized Health Care Education/Training Program | 2028 Timberlane Way, San Mateo, CA 94402-3937 | 2014-06-13 |
| 1427476712 | Nancy Yerkes Greenland | Student in an Organized Health Care Education/Training Program | 701 N El Camino Real, Apartment 302, San Mateo, CA 94401-3736 | 2014-04-03 |
| 1518190032 | Pamela Liliana San Cristobal | Student in an Organized Health Care Education/Training Program | 420 N Bayshore Blvd Apt 39, San Mateo, CA 94401-1260 | 2009-09-01 |
| 1306033592 | Barbara Herz | Student in an Organized Health Care Education/Training Program | 791 26th Ave, San Mateo, CA 94403-2634 | 2007-10-01 |
| 1639364664 | Yueming Wang | Student in an Organized Health Care Education/Training Program | 1683 Eleanor Dr, San Mateo, CA 94402-2654 | 2007-09-12 |
| 1811515489 | Naomi Symphony Noel Uyeda | Student in an Organized Health Care Education/Training Program | 222 Paul Scannell Dr, San Mateo, CA 94402-4061 | 2020-07-10 |
| 1629696265 | Kelsey Nichole Weiss | Student in an Organized Health Care Education/Training Program | 2000 Alameda De Las Pulgas, San Mateo, CA 94403-1269 | 2020-07-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.