Healthcare Provider Details

I. General information

NPI: 1639514441
Provider Name (Legal Business Name): ISAMAR ERMESE DELGADO LMFT 111868
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ISAMAR ERMESE BAEZA LMFT 111868

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 ROCKY RIDGE DR STE 120
ROSEVILLE CA
95661-2834
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number91709
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number111868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: