Healthcare Provider Details

I. General information

NPI: 1174394274
Provider Name (Legal Business Name): KAREN ISAK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 RIVER PARK PL W FRESNO CA 93720
FRESNO CA
93724-0001
US

IV. Provider business mailing address

9006 MORGANFIELD PL
ELK GROVE CA
95624-3608
US

V. Phone/Fax

Practice location:
  • Phone: 916-202-6761
  • Fax:
Mailing address:
  • Phone: 916-202-6761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95134941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: