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DR. PEOLIA KANSAS FONSWORTH M.D. M.B.A NPI 1639412091


NPI Information

NPI: 1639412091
Provider Name: DR. PEOLIA KANSAS FONSWORTH, M.D., M.B.A
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
1000 W CARSON ST
TORRANCE, CA
ZIP 90502
Phone: (310) 222-2345
Get Directions

DR. Peolia Kansas Fonsworth, M.D., M.B.A is an addiction medicine psychiatry neurology in Torrance, CA with 11 years of experience. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine DR. Peolia Kansas Fonsworth, M.D., M.B.A NPI is 1639412091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduation Year:2013

The provider's business location address is:

1000 W CARSON ST
TORRANCE, CA
ZIP 90502-004
Phone: (310) 222-2345

The NPI 1639412091 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychotherapy, 30 minutes (HCPCS:90833)
  • Psychotherapy, 30 minutes (HCPCS:90832)

The enumeration date for this NPI number is 4/3/2013 and was last updated on 6/21/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistA132680CALIFORNIANo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
32084A0401XPsychiatry & NeurologyAddiction MedicineA132680CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.