Healthcare Provider Details

I. General information

NPI: 1437539822
Provider Name (Legal Business Name): LEXIE ISAACS LEIGHTNER RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA ISAACS

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 N COAST HIGHWAY 101 STE A
ENCINITAS CA
92024-2074
US

IV. Provider business mailing address

4465 N MERIDIAN ST
INDIANAPOLIS IN
46208-3533
US

V. Phone/Fax

Practice location:
  • Phone: 202-932-9958
  • Fax:
Mailing address:
  • Phone: 317-903-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number37003689A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: