Individual ProviderCorina Jude FonteleraPharmacistPharmacy Service ProvidersPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809(707) 423-7657PECOS EnrollmentBased on the most recent information from CMS, provider Corina Jude Fontelera does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:10 AM.Profile DetailsProvider ID1336746791Provider TypeIndividualFull NameFontelera, Corina JudeGenderFemaleSole ProprietorYesEnumeration Date10/7/2020Last Updated5/17/2023Contact InformationPractice LocationPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7657Fax(707) 423-7994Mailing LocationMailing Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7657Fax(707) 423-7999Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense82714California