Andrew Lazaro Fonticiella, PASTUDENT
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
Practice location Address checks out
16037 Via Del SolSan Lorenzo, CA 94580-2407
Phone: (818) 935-7076
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
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 number | 1023814001 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PASTUDENT |
| Sole proprietor | No |
| NPI enumerated | February 20, 2025 |
| Last updated in NPPES | April 10, 2026 |
| Certification date | April 10, 2026 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| 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 |