=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487317608
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALIFORNIA RESILIENCE PSYCHIATRY, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2021
-----------------------------------------------------
Last Update Date | 06/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8273 TOP O THE MORNING WAY
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-266-9297
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 5000, PMB 54
-----------------------------------------------------
City | RANCHO SANTA FE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92067-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-223-5323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | ADINA FISCHER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 650-223-5334
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------