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

Individual provider Physical Therapist · NPI 1538749817

Nicolette Fonseca, PT, DPT is a Physical Therapist in Bandon, Oregon. Licensed in Kansas and Tennessee. Registered with an NPI since 2021.

Licensed in
KS, TN
In the registry since
2021
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

913 11th St SE Ste 2
Bandon, OR 97411-9168
Phone: (541) 347-4314
Fax: (541) 347-8006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11972 (TN)
Physical Therapist Taxonomy 225100000X · Licence 11-06089 (KS)

Record details

NPI number1538749817
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedApril 12, 2021
Last updated in NPPESApril 12, 2021
Certification dateMarch 20, 2021

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