Provider Demographics
NPI:1922124023
Name:FISCHER, RENA X (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MRS
First Name:RENA
Middle Name:X
Last Name:FISCHER
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 SHINGLE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682-6801
Mailing Address - Country:US
Mailing Address - Phone:530-306-4073
Mailing Address - Fax:
Practice Address - Street 1:3050 SHINGLE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:SHINGLE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95682-6801
Practice Address - Country:US
Practice Address - Phone:530-306-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC10561171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist