Individual provider Active NPI

Raenna Fisher

  • Marriage & Family Therapist
  • Redding, CA
National Provider Identifier
1154870004
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
84934 Issued in CA
Practice address
353 Park Marina Cir
Redding, CA 96001-0965
Phone
(530) 276-7492
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 84934 CA Primary

Addresses

Primary practice location

353 Park Marina Cir
Redding, CA 96001-0965

Mailing address

14594 Marti LN
Redding, CA 96003-7022
Phone (530) 276-7492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
84934CAMDPediatric Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1154870004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14594 MARTI LN",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960037022",
            "telephone_number": "530-276-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 PARK MARINA CIR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010965",
            "telephone_number": "530-276-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "RAENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.