Provider Demographics
NPI:1740009711
Name:LIN, ISABELLE
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:LIN
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3832 STEINBECK CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606
Mailing Address - Country:US
Mailing Address - Phone:949-491-2877
Mailing Address - Fax:
Practice Address - Street 1:2901 W MACARTHUR BLVD STE 207
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6972
Practice Address - Country:US
Practice Address - Phone:562-270-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist