Healthcare Provider Details

I. General information

NPI: 1962685156
Provider Name (Legal Business Name): DENA M FISHER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 EAST 31ST STREET
OAKLAND CA
94602
US

IV. Provider business mailing address

1411 EAST 31ST STREET
OAKLAND CA
94602
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-4373
  • Fax: 510-437-5170
Mailing address:
  • Phone: 510-437-4373
  • Fax: 510-437-5170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW15503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: