Healthcare Provider Details

I. General information

NPI: 1467527549
Provider Name (Legal Business Name): TIFFANY FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 TECH CENTER DR STE 175
SACRAMENTO CA
95826-2592
US

IV. Provider business mailing address

9343 TECH CENTER DR STE 175
SACRAMENTO CA
95826-2592
US

V. Phone/Fax

Practice location:
  • Phone: 916-477-3598
  • Fax:
Mailing address:
  • Phone: 916-477-3598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158793
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: