Healthcare Provider Details

I. General information

NPI: 1174384416
Provider Name (Legal Business Name): FLETCHER AND ASSOCIATES PSYCHIATRY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 OBERLIN DR STE 301
SAN DIEGO CA
92121-4717
US

IV. Provider business mailing address

PO BOX 26517
SAN DIEGO CA
92196-0517
US

V. Phone/Fax

Practice location:
  • Phone: 858-239-2277
  • Fax: 415-536-2977
Mailing address:
  • Phone: 858-239-2277
  • Fax: 415-536-2977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENT F FLETCHER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 858-239-2277