Healthcare Provider Details

I. General information

NPI: 1528811056
Provider Name (Legal Business Name): AARON FICHTNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 UNIVERSITY AVE
RIVERSIDE CA
92521-3315
US

IV. Provider business mailing address

900 UNIVERSITY AVE
RIVERSIDE CA
92521-9800
US

V. Phone/Fax

Practice location:
  • Phone: 951-827-9197
  • Fax: 951-827-7669
Mailing address:
  • Phone: 951-827-9197
  • Fax: 951-827-7669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberPTL16101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: