MITZI CAROLINA FOGG R.N. M.S.N. F.N.P. NPI 1881802148

NPI Information

NPI: 1881802148
Provider Name: MITZI CAROLINA FOGG, R.N., M.S.N., F.N.P.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
1801 E COTATI AVE
ROHNERT PARK, CA
ZIP 94928
Phone: (707) 664-2921
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Mitzi Carolina Fogg, R.N., M.S.N., F.N.P. is a family nurse practitioner in Rohnert Park, CA. Mitzi Carolina Fogg, R.N., M.S.N., F.N.P. NPI is 1881802148. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1801 E COTATI AVE
ROHNERT PARK, CA
ZIP 94928-609
Phone: (707) 664-2921
Fax: (707) 664-2925

The enumeration date for this NPI number is 5/18/2007 and was last updated on 3/23/2021.

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
1	363LF0000X	Nurse Practitioner	Family	633049	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1881802148	MEDICAID	CALIFORNIA

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: 11/14/2023

NPI Synchronization or Removal

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