Provider Demographics
NPI:1073675419
Name:FISHER, LEAH POTTS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:POTTS
Last Name:FISHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ARDITH DR
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-4202
Mailing Address - Country:US
Mailing Address - Phone:925-376-9141
Mailing Address - Fax:925-376-3766
Practice Address - Street 1:7 SANTA MARIA WAY
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2604
Practice Address - Country:US
Practice Address - Phone:925-376-9141
Practice Address - Fax:925-376-3766
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS41191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical