Healthcare Provider Details

I. General information

NPI: 1477982668
Provider Name (Legal Business Name): HAROLD ISAAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 W CECIL AVE
DELANO CA
93215-1821
US

IV. Provider business mailing address

PO BOX 1094
VISALIA CA
93279-1094
US

V. Phone/Fax

Practice location:
  • Phone: 661-721-2345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number79597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: