Healthcare Provider Details

I. General information

NPI: 1558277624
Provider Name (Legal Business Name): ISAI BARAHONA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 ROSEBAY DR
ENCINITAS CA
92024-3323
US

IV. Provider business mailing address

143 ROSEBAY DR
ENCINITAS CA
92024-3323
US

V. Phone/Fax

Practice location:
  • Phone: 760-468-8737
  • Fax:
Mailing address:
  • Phone: 760-468-8737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number27162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: