Provider Demographics
NPI:1043406309
Name:FISHER, JACQUELINE PATRICIA LOUISE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:PATRICIA LOUISE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E TAHQUITZ CANYON WAY STE 117
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6788
Mailing Address - Country:US
Mailing Address - Phone:760-320-3838
Mailing Address - Fax:760-320-3733
Practice Address - Street 1:134 E HOBSONWAY STE 5
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1778
Practice Address - Country:US
Practice Address - Phone:760-320-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist