Healthcare Provider Details

I. General information

NPI: 1811804594
Provider Name (Legal Business Name): MEGAN FISTER SHSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 24TH ST APT 628
OAKLAND CA
94612-4912
US

IV. Provider business mailing address

312 24TH ST APT 628
OAKLAND CA
94612-4912
US

V. Phone/Fax

Practice location:
  • Phone: 510-213-2672
  • Fax:
Mailing address:
  • Phone: 510-213-2672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: