Provider Demographics
NPI:1477030104
Name:OSORNIO, MARIA ISABEL (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:OSORNIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 N HIGHWAY 59 STE K
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9405
Mailing Address - Country:US
Mailing Address - Phone:209-726-3090
Mailing Address - Fax:209-722-7648
Practice Address - Street 1:3360 N HIGHWAY 59 STE K
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348
Practice Address - Country:US
Practice Address - Phone:209-726-3090
Practice Address - Fax:209-722-7648
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CA1142621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional