Provider Demographics
NPI:1912795196
Name:CHRISTOPHER FONSECA, KRYSNEY ALVES (RN)
Entity type:Individual
Prefix:
First Name:KRYSNEY
Middle Name:ALVES
Last Name:CHRISTOPHER FONSECA
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:KRYSNEY
Other - Middle Name:
Other - Last Name:ALVES FONSECA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3265 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-3511
Mailing Address - Country:US
Mailing Address - Phone:414-217-3897
Mailing Address - Fax:
Practice Address - Street 1:2825 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6039
Practice Address - Country:US
Practice Address - Phone:916-887-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95255104163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse