Fides G Isidro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW110005 Issued in CA

Practice address

11152 Wallingsford Rd Apt 7C
Los Alamitos, CA 90720-3089

Phone

(908) 494-2338

Fax

(562) 296-8105

NPI assigned

Apr 22, 2007

Last updated

Apr 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Ms. Desi Isidro Professional name

Medicare fee-for-service enrollment

Enrolled in NJ, NY, CA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

WK Medical GroupGroup PAC ID 6103116348, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• WK Medical Group

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1588083992

  Clinical

  Medicare reassignment Care Compare group NPD
• Center for New Directions, Inc.

  • Mental Health Counselor
  • Laguna Hills, CA
  • NPI 1578121190
  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• LGTC Group

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1881482941

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, NY

  Medicare reassignment NPD
• LGTC Inc

  dba LGTC

  • Registered Dietitian
  • San Jose, CA
  • NPI 1710749494
  NPD (past)
• Los Gatos Therapy Center

  dba LGTC Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1518600972
  NPD (past)
• Stephen M Pumphrey Licensed Clinical Social Workers Inc

  • Clinical Social Worker
  • Laguna Hills, CA
  • NPI 1386862969
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1427276013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11152 WALLINGSFORD RD APT 7C",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203089",
            "telephone_number": "908-494-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11152 WALLINGSFORD RD APT 7C",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203089",
            "telephone_number": "908-494-2338",
            "fax_number": "562-296-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIDRO",
        "first_name": "FIDES",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05287800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080981-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW110005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESI",
            "last_name": "ISIDRO",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Infocus Pathology Group
• Innovative Psychological Solutions
• Integrated Dermatology of Los Alamitos, PC
• Integrated Pathology Medical Laboratory, Inc. (Lotus Laboratories)
• Susan Ishioka, DDS, MS
• Stephanie Paola Islas Orgaz
• Amanda Brooke Israel, DDS
• Barry Dean Israel, DDS
• Jack Rubin MD, a Prof Corporation
• Michael John Jackson, MPT, B.ED.

• Clinical Social Worker in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.