Healthcare Provider Details

I. General information

NPI: 1457260762
Provider Name (Legal Business Name): ISAMAR CHAPARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W KILBURN ST
TUCSON AZ
85705-9234
US

IV. Provider business mailing address

1508 W KILBURN ST
TUCSON AZ
85705-9234
US

V. Phone/Fax

Practice location:
  • Phone: 520-465-2696
  • Fax:
Mailing address:
  • Phone: 520-465-2696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number25108497
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: