Provider Demographics
NPI:1508645714
Name:TOWNSEND, ISIAH (BS)
Entity Type:Individual
Prefix:
First Name:ISIAH
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 SHADY WILLOW LN UNIT 2A
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5393
Mailing Address - Country:US
Mailing Address - Phone:510-313-8212
Mailing Address - Fax:
Practice Address - Street 1:4438 BUCKEYE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-9334
Practice Address - Country:US
Practice Address - Phone:925-755-8499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator