Provider Demographics
NPI:1902667025
Name:FISHER, ROCHELLE DENISE
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:DENISE
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18764 W BYRON RD # 210
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95391-9713
Mailing Address - Country:US
Mailing Address - Phone:650-244-1444
Mailing Address - Fax:650-244-1777
Practice Address - Street 1:508 7TH AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4522
Practice Address - Country:US
Practice Address - Phone:650-204-3113
Practice Address - Fax:650-244-1777
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)