Healthcare Provider Details

I. General information

NPI: 1275177982
Provider Name (Legal Business Name): FUSION CARE GROUP, A PSYCHOLOGICAL PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2271 ALPINE BLVD STE A
ALPINE CA
91901-1101
US

IV. Provider business mailing address

2271 ALPINE BLVD STE A
ALPINE CA
91901-1101
US

V. Phone/Fax

Practice location:
  • Phone: 619-448-1216
  • Fax: 888-291-4799
Mailing address:
  • Phone: 619-448-1216
  • Fax: 888-291-4799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTIANA KATARINA SILVA
Title or Position: PRESIDENT
Credential: PHD
Phone: 619-448-1216