Doctor Name: | MR. JAMES WILLIAM ISHERWOOD |
NPI Number: | 1861801151 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 51433 |
Business Practice Address: | 6302 Thirteenth Ave Lucerne, CA - 95458 |
Business Phone Number: | 7072749101 |
Business Fax Number: | 7072749192 |
Mailing Address: | Po Box 1024, LUCERNE |
State: | CA |
Postal Code: | 954581024 |
Phone Number: | 7072749101 |
Fax Number: | 7072749101 |
NPI Enumeration Date: | 08/12/2014 |
NPI Last Update Date: | 12/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 51433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |