Healthcare Provider Details

I. General information

NPI: 1942449772
Provider Name (Legal Business Name): DEBRA FISHMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C ST STE 1500
SACRAMENTO CA
95816-3371
US

IV. Provider business mailing address

3630 BUSINESS DR
SACRAMENTO CA
95820-2163
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7463
  • Fax: 916-734-1500
Mailing address:
  • Phone: 916-734-4291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY22462
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY22462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: