Healthcare Provider Details

I. General information

NPI: 1528822525
Provider Name (Legal Business Name): MARY KHRISTEEN J ISIDRO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 TEMPLE AVE STE B
SIGNAL HILL CA
90755-2212
US

IV. Provider business mailing address

5360 SILVER CANYON RD UNIT D
YORBA LINDA CA
92887-3940
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-7500
  • Fax: 562-424-9588
Mailing address:
  • Phone: 949-945-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95029020
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: