Healthcare Provider Details

I. General information

NPI: 1114002243
Provider Name (Legal Business Name): SANDI J. FISCHER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 VENTURA BLVD SUITE 230
STUDIO CITY CA
91604-2406
US

IV. Provider business mailing address

12400 VENTURA BLVD SUITE 230
STUDIO CITY CA
91604-2406
US

V. Phone/Fax

Practice location:
  • Phone: 818-506-4194
  • Fax: 818-506-6921
Mailing address:
  • Phone: 818-506-4194
  • Fax: 818-506-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY11726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: