Provider Demographics
NPI:1205714235
Name:DE LA HOZ ISAZA, JENNIFHER M
Entity type:Individual
Prefix:
First Name:JENNIFHER
Middle Name:M
Last Name:DE LA HOZ ISAZA
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 1:267 PORT AUGUSTINE CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4839
Mailing Address - Country:US
Mailing Address - Phone:813-407-8008
Mailing Address - Fax:
Practice Address - Street 1:267 PORT AUGUSTINE CIR APT 202
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4839
Practice Address - Country:US
Practice Address - Phone:813-407-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-25-456485106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician