Tara Lenee Fischetti, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21702 Issued in CA

Practice address

1081 Westwood Blvd
Suite # 221
Los Angeles, CA 90024-2911

Phone

(310) 460-8438

NPI assigned

Jun 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tara Lenee Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1700106259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25722",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900250722",
            "telephone_number": "310-460-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 WESTWOOD BLVD",
            "address_2": "SUITE # 221",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242911",
            "telephone_number": "310-460-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHETTI",
        "first_name": "TARA",
        "middle_name": "LENEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2022-02-11",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3900 Broadway",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "LENEE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jesse Thomas Fischer, PHD
• Kyle Christopher Fischer, PHARMD
• Matthew Adam Fischer, M.D.
• Michael Fischer, M.D.
• Murray Fischer, RT
• Tiffany Joy Fischman, M.D.
• Amy Fiser
• Alexander Fish, MD
• David Eli Fish, MD, MPH
• Kari Marie Fish, FNP-C

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.