Provider Demographics
NPI:1275177982
Name:FUSION CARE GROUP, A PSYCHOLOGICAL PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:FUSION CARE GROUP, A PSYCHOLOGICAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:KATARINA
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-448-1216
Mailing Address - Street 1:2271 ALPINE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-1101
Mailing Address - Country:US
Mailing Address - Phone:619-448-1216
Mailing Address - Fax:888-291-4799
Practice Address - Street 1:2271 ALPINE BLVD STE A
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-1101
Practice Address - Country:US
Practice Address - Phone:619-448-1216
Practice Address - Fax:888-291-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty