Individual provider Active NPI

Nadeen Karen Fisher, PH.D

  • Clinical Psychologist
  • Reseda, CA
National Provider Identifier
1629280045
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12207 Issued in CA
Practice address
18546 Sherman Way
Suite 202
Reseda, CA 91335-4117
Phone
(818) 326-4671
Fax
(805) 496-5379
NPI assigned
May 6, 2007
Last updated
Jun 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY12207 CA Primary

Addresses

Primary practice location

18546 Sherman Way
Suite 202
Reseda, CA 91335-4117

Mailing address

729 N Valley Dr
Westlake Village, CA 91362-3708
Phone (818) 326-4671

Other identifiers 1

IdentifierTypeStateIssuer
PSY122070MedicaidCA

Other names 1

  • Dr. Nadeen Wolff Fisher Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040120000806 CA Practitioner - Clinical Psychologist 8224939368 Practice locations: Calabasas, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Southern California Keck School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4768 Park Granada
Suite 109
Calabasas, CA 91302-3312
Phone 818326467100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12207CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1629280045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 N VALLEY DR",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623708",
            "telephone_number": "818-326-4671",
            "fax_number": "805-496-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18546 SHERMAN WAY",
            "address_2": "SUITE 202",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354117",
            "telephone_number": "818-326-4671",
            "fax_number": "805-496-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "NADEEN",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-06",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY122070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADEEN",
            "last_name": "FISHER",
            "middle_name": "WOLFF",
            "prefix": "DR.",
            "credential": "PH.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Reseda, CA

Sources for this page

Verify at the official NPI Registry.