Provider Demographics
NPI:1912096942
Name:FISCH, ALLYSON ANDERS (GNP, RD)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:ANDERS
Last Name:FISCH
Suffix:
Gender:F
Credentials:GNP, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VETERANS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1715
Mailing Address - Country:US
Mailing Address - Phone:650-299-4959
Mailing Address - Fax:
Practice Address - Street 1:900 VETERANS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1715
Practice Address - Country:US
Practice Address - Phone:650-299-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15058363L00000X
CA868844133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02800ZOtherPPIN