Provider Demographics
NPI:1215763339
Name:EKIZIAN, ISABELLA GRACE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:GRACE
Last Name:EKIZIAN
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 1:1091 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-1087
Mailing Address - Country:US
Mailing Address - Phone:559-859-0619
Mailing Address - Fax:
Practice Address - Street 1:701 W KIMBERLY AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6342
Practice Address - Country:US
Practice Address - Phone:714-495-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician