Provider Demographics
NPI:1851572440
Name:FISHER PSYCHIARTIC SERVICES, INC.
Entity type:Organization
Organization Name:FISHER PSYCHIARTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DUKE
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-938-6100
Mailing Address - Street 1:257 CASTRO ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1285
Mailing Address - Country:US
Mailing Address - Phone:650-938-6100
Mailing Address - Fax:650-938-6101
Practice Address - Street 1:257 CASTRO ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-1285
Practice Address - Country:US
Practice Address - Phone:650-938-6100
Practice Address - Fax:650-938-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86657261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)