Healthcare Provider Details

I. General information

NPI: 1114372174
Provider Name (Legal Business Name): CRAIG FISHER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E CANON PERDIDO ST STE 204
SANTA BARBARA CA
93101-2286
US

IV. Provider business mailing address

1375 E GRAND AVE # 126
ARROYO GRANDE CA
93420-2421
US

V. Phone/Fax

Practice location:
  • Phone: 805-699-6252
  • Fax:
Mailing address:
  • Phone: 954-592-4336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number57999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: