=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114247095
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. KATHLEEN MARIE FISCHER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2010
-----------------------------------------------------
Last Update Date | 06/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5500 CLARK RD
-----------------------------------------------------
City | PARADISE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95969-5106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-872-5500
-----------------------------------------------------
Fax | 530-872-7423
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5500 CLARK RD
-----------------------------------------------------
City | PARADISE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95969-5106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-872-5500
-----------------------------------------------------
Fax | 530-872-7423
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | HA7599
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------