Individual provider Active NPI

Dena Marie Fisher, P.A,

  • Physician Assistant
  • Garden Grove, CA
National Provider Identifier
1821270273
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21503 Issued in CA
Practice address
12462 Brookhurst St
Suite a&B
Garden Grove, CA 92840-4759
Phone
(714) 636-9850
NPI assigned
Nov 28, 2007
Last updated
Jun 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21503 CA Primary

Addresses

Primary practice location

12462 Brookhurst St
Suite a&B
Garden Grove, CA 92840-4759

Mailing address

12462 Brookhurst St
Suite a&B
Garden Grove, CA 92840-4759
Phone (714) 636-9850

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110909002740 CA Practitioner - Physician Assistant 0547348377 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883-3627
Phone (951) 293-4722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGOKMDDiagnostic Radiology Physician
PA21503CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Star Hospital Associates Inc. CurrentSince Sep 1, 2021 Accepting new patients
Orange County Urgent Care #3, Inc. CurrentSince Jun 20, 2020 Accepting new patients
Carbon Health Primary Care of California PC PastSince Apr 5, 2021 Accepting new patients

Locations

820 E Mountain View St
Barstow, CA 92311
Phone (760) 256-1761

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

82151 Avenue 42
Ste 100
Indio, CA 92203
Phone (442) 215-1320

78965 Highway 111
Ste 100
La Quinta, CA 92253
Phone (706) 777-7847

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1821270273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12462 BROOKHURST ST",
            "address_2": "SUITE A&B",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404759",
            "telephone_number": "714-636-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 BROOKHURST ST",
            "address_2": "SUITE A&B",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404759",
            "telephone_number": "714-636-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DENA",
        "middle_name": "MARIE",
        "credential": "P.A,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.