Provider Demographics
NPI:1851849244
Name:PAZMINO, ISABELLA (MFT)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:PAZMINO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 HIGHWAY A1A APT 2406
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3585
Mailing Address - Country:US
Mailing Address - Phone:321-474-0826
Mailing Address - Fax:
Practice Address - Street 1:679 S NEW HAMPSHIRE AVE
Practice Address - Street 2:3RD FLOOR SUITE 350
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1355
Practice Address - Country:US
Practice Address - Phone:213-385-5100
Practice Address - Fax:213-807-1995
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115367106H00000X
CA#94628106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA115367OtherBOARD OF BEHAVIORAL SCIENCES