Provider Demographics
NPI:1891330064
Name:MC ISAAC, CHRISTINE
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:
Last Name:MC ISAAC
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 1:1401 N TUSTIN AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8656
Mailing Address - Country:US
Mailing Address - Phone:714-730-7700
Mailing Address - Fax:
Practice Address - Street 1:1401 N TUSTIN AVE STE 270
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8656
Practice Address - Country:US
Practice Address - Phone:714-730-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27360235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist