Provider Demographics
NPI:1114487923
Name:SERRANO, ISAI (LCSW)
Entity type:Individual
Prefix:
First Name:ISAI
Middle Name:
Last Name:SERRANO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79505 CAMELBACK DR
Mailing Address - Street 2:
Mailing Address - City:BERMUDA DUNES
Mailing Address - State:CA
Mailing Address - Zip Code:92203-1485
Mailing Address - Country:US
Mailing Address - Phone:657-784-1997
Mailing Address - Fax:
Practice Address - Street 1:79505 CAMELBACK DR
Practice Address - Street 2:
Practice Address - City:BERMUDA DUNES
Practice Address - State:CA
Practice Address - Zip Code:92203-1485
Practice Address - Country:US
Practice Address - Phone:657-784-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1289951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical