Provider Demographics
NPI:1528240124
Name:FISCHER, NANCY DEVRA (MSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:DEVRA
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:DEVRA
Other - Middle Name:
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9300 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3213
Mailing Address - Country:US
Mailing Address - Phone:310-858-7433
Mailing Address - Fax:
Practice Address - Street 1:9300 WILSHIRE BLVD
Practice Address - Street 2:SUITE 510
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3213
Practice Address - Country:US
Practice Address - Phone:310-858-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 169531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 16953Medicare PIN