Healthcare Provider Details

I. General information

NPI: 1184880858
Provider Name (Legal Business Name): ISABEL BATRES PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16756 CHINO CORONA RD
EASTVALE CA
92880-9508
US

IV. Provider business mailing address

PO BOX 8553
LA VERNE CA
91750-8553
US

V. Phone/Fax

Practice location:
  • Phone: 909-597-1771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY25693
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: