MEDICARE: DR. INNA FISHMAN PHD

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	103G00000X	Clinical Neuropsychologist		CA

General Provider Information

NPI Number	:	1598611717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INNA FISHMAN PHD

Provider Business Mailing Address
First Line	:	6363 ALVARADO CT STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-4913
Country	:	US
Telephone Number	:	619-594-2299
Fax Number	:

Provider Business Practice Location Address
First Line	:	6363 ALVARADO CT STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-4913
Country	:	US
Telephone Number	:	619-594-2299
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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