Provider Demographics
NPI:1467035659
Name:PINA, ISABEL
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:PINA
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 1:1161 BAY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2670
Mailing Address - Country:US
Mailing Address - Phone:619-585-7686
Mailing Address - Fax:619-585-7699
Practice Address - Street 1:1161 BAY BLVD STE B
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2670
Practice Address - Country:US
Practice Address - Phone:619-585-7686
Practice Address - Fax:619-585-7699
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program