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Organization
4TH SECOND
Active
Organization
4TH SECOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY FISHER MD (DIRECTOR OF COMMUNITY HEALTH)
(530) 574-4847
Entity
Organization
Contact information
Practice address
929 AMADOR ST, VALLEJO, CA 94590-4606
(707) 335-0300
Mailing address
839 VALLE VISTA AVE, VALLEJO, CA 94590-3542
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251X00000X
Supports Brokerage Agency
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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