| Tara Fishback, PHD | |
|
3825 Hopyard Rd Ste 220, Pleasanton, CA 94588-2786 | |
| (925) 847-5051 | |
| Not Available |
| Full Name | Tara Fishback |
|---|---|
| Gender | Female |
| Speciality | Psychologist - Clinical |
| Location | 3825 Hopyard Rd Ste 220, Pleasanton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295546232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY35620 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Fishback, PHD 4415 Valley Ave Apt K, Pleasanton, CA 94566-5583 Ph: Not Available | Tara Fishback, PHD 3825 Hopyard Rd Ste 220, Pleasanton, CA 94588-2786 Ph: (925) 847-5051 |
Ms. Valerie Lee Gannon, MFT Psychologist Medicare: Not Enrolled in Medicare Practice Location: 91 W Neal St, Pleasanton, CA 94566 Phone: 925-890-6764 |
Dr. Elizabeth Fox Butler, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4713 1st St, Ste 254, Pleasanton, CA 94566 Phone: 925-421-6868 Fax: 925-462-0545 |
Dr. Vida Wong, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5674 Stoneridge Dr Ste 218, Pleasanton, CA 94588 Phone: 925-307-6563 |
Dr. Sara Marie Sanders, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7901 Stoneridge Dr, Suite 521, Pleasanton, CA 94588 Phone: 925-216-5651 |
Shanequia Shannon, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5776 Stoneridge Mall Rd Ste 340, Pleasanton, CA 94588 Phone: 925-223-8047 |
Dr. Jacqueline Golding, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1400 Santa Rita Rd, Suite K, Pleasanton, CA 94566 Phone: 925-484-2237 Fax: 925-484-1879 |
Mr. Mark Dennis Denbroeder, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5776 Stoneridge Mall Road, Suite 140, Pleasanton, CA 94588 Phone: 925-734-8772 Fax: 925-467-1497 |