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Individual
TRAVIS RANDALL FISCHER
Active
Individual
TRAVIS RANDALL FISCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1458280222
CA
171M00000X
Case Manager/Care Coordinator
Primary
CI4270524
CA
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
MPSS-TBYHIP
CA
Other
Enumeration date
02/16/2022
Last updated
09/13/2024
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