Provider Demographics
NPI:1922212489
Name:DELONGPRE, ISPA
Entity Type:Individual
Prefix:
First Name:ISPA
Middle Name:
Last Name:DELONGPRE
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 1:318 CARMEN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7754
Mailing Address - Country:US
Mailing Address - Phone:805-922-2106
Mailing Address - Fax:805-922-2751
Practice Address - Street 1:318 CARMEN LN
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-7754
Practice Address - Country:US
Practice Address - Phone:805-922-2106
Practice Address - Fax:805-922-2751
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator