Basic Information
| Provider Information | |||||||||
| NPI: | 1205934734 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLEMING | ||||||||
| FirstName: | INDIA | ||||||||
| MiddleName: | CHRISTIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7601 HOSPITAL DR | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958235408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166811600 | ||||||||
| FaxNumber: | 9166880225 | ||||||||
| Practice Location | |||||||||
| Address1: | 7601 HOSPITAL DR | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958235408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166811600 | ||||||||
| FaxNumber: | 9166880225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY12316 | CA | Y | Behavioral Health & Social Service Providers | Psychologist |
ID Information
| ID | Type | State | Issuer | Description | PSY 12316 | 01 | CA | LICENSE | OTHER |