Christine Tracy Fishero-Fazio, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

10-06-3112 Issued in FL

Practice address

1321 McClelland Ave
Port St Joe, FL 32456-2041

Phone

(850) 227-4392

Fax

(850) 229-6166

NPI assigned

Feb 22, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1235260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1760622385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3076 ANDERSON RD",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439301",
            "telephone_number": "850-227-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 MCCLELLAND AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324562041",
            "telephone_number": "850-227-4392",
            "fax_number": "850-229-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHERO-FAZIO",
        "first_name": "CHRISTINE",
        "middle_name": "TRACY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-22",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "10-06-3112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome Garciano Enad, MD
• Eye Center of North Florida, P.a.
• Daniel Raymond Farrell, M.D.
• Sheila Renee Fennell
• Melissa Sue Finch
• Florida Department of Health
• Rachel Ashton Forrest, OTR/L
• Patricia A Fults, MDH
• Iris Levon Gathers, CERTIFIED HAIR LOSS
• Geri Care Assisted Living and Rehabilitation Center

• Behavior Analyst in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.