Provider Demographics
NPI:1891350716
Name:O'BRIEN, ISABEL KATHRYN (MS)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:KATHRYN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4463 IDAHO ST APT 13
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-5126
Mailing Address - Country:US
Mailing Address - Phone:408-802-5568
Mailing Address - Fax:
Practice Address - Street 1:2820 CAMINO DEL RIO S STE 308
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3824
Practice Address - Country:US
Practice Address - Phone:619-546-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP36052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist