Healthcare Provider Details

I. General information

NPI: 1811120405
Provider Name (Legal Business Name): ANGELA DURAN ISAACS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA DURAN

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 ROSE AVE
SELMA CA
93662-3240
US

IV. Provider business mailing address

2643 N CHINOWTH ST
VISALIA CA
93291-8077
US

V. Phone/Fax

Practice location:
  • Phone: 559-856-6090
  • Fax:
Mailing address:
  • Phone: 619-961-8861
  • Fax: 559-737-4782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number925872
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: