MEDICARE: ISAMARRA TERESITA ZEPEDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	106H00000X	Marriage & Family Therapist	LMFT110497	CA

General Provider Information

NPI Number	:	1528469186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAMARRA TERESITA ZEPEDA

Provider Business Mailing Address
First Line	:	771 W. BLAINE ST.
Second Line	:	SUITE C & D
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-3940
Country	:	US
Telephone Number	:	951-358-6726
Fax Number	:

Provider Business Practice Location Address
First Line	:	771 W. BLAINE ST
Second Line	:	SUITE C & D
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-3940
Country	:	US
Telephone Number	:	951-358-6726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	04/13/2026

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