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NPI Code Detail

MEDICARE: ALYSON DIROCCO FISHER PSYD

MEDICARE:   ALYSON DIROCCO FISHER  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY32858CA

General Provider Information

NPI Number : 1396263547
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSON DIROCCO FISHER PSYD
Provider Business Mailing Address
First Line : 11340 W OLYMPIC BLVD STE 268
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1612
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11340 W OLYMPIC BLVD STE 268
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1612
Country : US
Telephone Number : 310-668-4480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2017
Last Update Date : 05/08/2023

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