Provider Demographics
NPI:1104642552
Name:ISAKSEN, MEREDITH (AMFT 151125)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:
Last Name:ISAKSEN
Suffix:
Gender:F
Credentials:AMFT 151125
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5332
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-0332
Mailing Address - Country:US
Mailing Address - Phone:510-214-6496
Mailing Address - Fax:
Practice Address - Street 1:1664 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2118
Practice Address - Country:US
Practice Address - Phone:510-214-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist