Healthcare Provider Details

I. General information

NPI: 1164655437
Provider Name (Legal Business Name): ISELA TENORIO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E HERMOSA ST
LINDSAY CA
93247-2124
US

IV. Provider business mailing address

320 BEVERLY PL
EXETER CA
93221-1055
US

V. Phone/Fax

Practice location:
  • Phone: 559-562-8292
  • Fax:
Mailing address:
  • Phone: 562-533-0851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW29006
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: