Provider Demographics
NPI:1851846927
Name:LANDEROS, ISBETH (MFTI)
Entity type:Individual
Prefix:
First Name:ISBETH
Middle Name:
Last Name:LANDEROS
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 15TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-4317
Mailing Address - Country:US
Mailing Address - Phone:510-478-3653
Mailing Address - Fax:
Practice Address - Street 1:25 N 14TH ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6217
Practice Address - Country:US
Practice Address - Phone:408-569-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health