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General NPI Number Information
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NPI Number | 1396531919
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Entity Type | Organization
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Legal Business Name | THERAPY ROOM, ISAI SERRANO, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 79505 CAMELBACK DR
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City | BERMUDA DUNES
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State | CA
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Zip | 92203-1485
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Country | US
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Telephone | 657-791-6082
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Fax |
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Provider Business Mailing Address
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Address Line | 927 S BRUCE ST APT 8
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City | ANAHEIM
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State | CA
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Zip | 92804-1113
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Country | US
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Telephone | 657-791-6082
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ISAI SERRANO
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Credential | LCSW
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Telephone | 760-391-7108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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