Provider Demographics
NPI:1912030115
Name:FISHER, PAMELA JOYCE
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JOYCE
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 JEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-5432
Mailing Address - Country:US
Mailing Address - Phone:530-790-7975
Mailing Address - Fax:
Practice Address - Street 1:539 GARDEN HWY
Practice Address - Street 2:SUITE B
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6318
Practice Address - Country:US
Practice Address - Phone:530-822-7133
Practice Address - Fax:530-822-7213
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)