MEDICARE: SANDI J. FISCHER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY11726	CA

General Provider Information

NPI Number	:	1114002243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDI J. FISCHER PH.D.

Provider Business Mailing Address
First Line	:	12400 VENTURA BLVD
Second Line	:	SUITE 230
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2406
Country	:	US
Telephone Number	:	818-506-4194
Fax Number	:	818-506-6921

Provider Business Practice Location Address
First Line	:	12400 VENTURA BLVD
Second Line	:	SUITE 230
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2406
Country	:	US
Telephone Number	:	818-506-4194
Fax Number	:	818-506-6921

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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