Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marcel Fomotar, CRNP-PMH

Individual provider Psychiatric/Mental Health Registered Nurse · NPI 1447765409

Marcel Fomotar, CRNP-PMH is a Nurse Practitioner in Clovis, California. Graduated from University of South Alabama College of Medicine in 2022, 4 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California and Maryland.

Years since qualifying
4
Trained at
University of South Alabama College of Medicine
Licensed in
CA, MD
In the registry since
2017
Specialties on file
3

Practice location Address checks out

1085 Sanders Ave
Clovis, CA 93619-3935
Phone: (408) 449-6623
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 601 E Naylor Mill Rd Unit F, Salisbury, MD 21804-2256 — (410) 572-4738

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95014417 (CA)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence 95043929 (CA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence R244114 (MD)

Record details

NPI number1447765409
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP-PMH
Sole proprietorYes
NPI enumeratedDecember 12, 2017
Last updated in NPPESSeptember 16, 2022
Certification dateSeptember 16, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Clovis