Healthcare Provider Details

I. General information

NPI: 1568289304
Provider Name (Legal Business Name): ESMERALDA ISORDIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 IOWA AVE STE 101
RIVERSIDE CA
92507-7428
US

IV. Provider business mailing address

2020 IOWA AVE STE 101
RIVERSIDE CA
92507-7428
US

V. Phone/Fax

Practice location:
  • Phone: 951-580-1026
  • Fax:
Mailing address:
  • Phone: 951-580-1026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22239
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: