Healthcare Provider Details

I. General information

NPI: 1922124023
Provider Name (Legal Business Name): RENA X FISCHER ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 SHINGLE SPRINGS DR
SHINGLE SPRINGS CA
95682-6801
US

IV. Provider business mailing address

3050 SHINGLE SPRINGS DR
SHINGLE SPRINGS CA
95682-6801
US

V. Phone/Fax

Practice location:
  • Phone: 530-306-4073
  • Fax:
Mailing address:
  • Phone: 530-306-4073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberL.AC10561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: