Provider Demographics
NPI:1467037150
Name:JANELLE K FISHER
Entity Type:Organization
Organization Name:JANELLE K FISHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:KIANNA
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:916-265-4008
Mailing Address - Street 1:4931 ARNOLD AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:MCCLELLAN
Mailing Address - State:CA
Mailing Address - Zip Code:95652-2528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4931 ARNOLD AVE STE 10
Practice Address - Street 2:
Practice Address - City:MCCLELLAN
Practice Address - State:CA
Practice Address - Zip Code:95652-2528
Practice Address - Country:US
Practice Address - Phone:916-265-4008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-14
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty