Provider Demographics
NPI:1326785783
Name:ISAIS, DEVONA
Entity Type:Individual
Prefix:
First Name:DEVONA
Middle Name:
Last Name:ISAIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 SOFTWIND DR
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7461
Mailing Address - Country:US
Mailing Address - Phone:559-467-9534
Mailing Address - Fax:
Practice Address - Street 1:13944 S ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-9207
Practice Address - Country:US
Practice Address - Phone:559-556-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician