Provider Demographics
NPI:1700948510
Name:IXCARAGUA, ISOLINA (LMFT)
Entity Type:Individual
Prefix:DR
First Name:ISOLINA
Middle Name:
Last Name:IXCARAGUA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LINA
Other - Middle Name:
Other - Last Name:IXCARAGUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:511 N BROOKHURST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5229
Mailing Address - Country:US
Mailing Address - Phone:909-919-6336
Mailing Address - Fax:
Practice Address - Street 1:11019 REICHLING LN
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-1508
Practice Address - Country:US
Practice Address - Phone:909-919-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46442106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist