Active NPI
Andrew Bruce Fisher, PH.D.
- Prescribing (Medical) Psychologist
- Oakland, CA
National Provider Identifier
1619193273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- PSY9638
- Practice address
- 5665 College Ave
Suite 340a
Oakland, CA 94618-1625 - Phone
- (510) 547-6223
- Fax
- (510) 420-0888
- NPI assigned
- Apr 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | PSY9638 | CA | Primary |
Addresses
Primary practice location
5665 College Ave
Suite 340a
Oakland, CA 94618-1625
Mailing address
237 Park View Ave
Piedmont, CA 94610-1041
Phone (510) 658-5363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120319000408 | CA | Practitioner - Psychologist Billing Independently | 6709046394 | Practice locations: Vallejo, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
532 Oregon St
Vallejo, CA 94590-3254
Phone (707) 643-8707
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY9638 | CA | MD | Prescribing (Medical) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619193273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "237 PARK VIEW AVE",
"city": "PIEDMONT",
"state": "CA",
"postal_code": "946101041",
"telephone_number": "510-658-5363",
"fax_number": "510-658-5398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5665 COLLEGE AVE",
"address_2": "SUITE 340A",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946181625",
"telephone_number": "510-547-6223",
"fax_number": "510-420-0888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "ANDREW",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "CA",
"license": "PSY9638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.