Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Andrew Lazaro Fonticiella, PASTUDENT

Individual provider Physician Assistant · NPI 1023814001

Andrew Lazaro Fonticiella, PASTUDENT is a Physician Assistant in San Lorenzo, California. Qualified in 2025, 1 year ago. Practices with Team Physicians of California Medical Group Inc, a 88-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

16037 Via Del Sol
San Lorenzo, CA 94580-2407
Phone: (818) 935-7076
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA67745 (CA)

Record details

NPI number1023814001
Entity typeIndividual (Type 1)
GenderMale
Credentials PASTUDENT
Sole proprietorNo
NPI enumeratedFebruary 20, 2025
Last updated in NPPESApril 10, 2026
Certification dateApril 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Team Physicians Of California Medical Group Inc — 88 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Adventist Health Lodi Memorial Hospital · Lodi, CA

Colleagues at Team Physicians of California Medical Group Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 88 clinicians in the practice; 12 are shown here.