Healthcare Provider Details

I. General information

NPI: 1134023211
Provider Name (Legal Business Name): CARISSA JOY HOWARD APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 INDIANA AVE STE 130
RIVERSIDE CA
92506-4266
US

IV. Provider business mailing address

6800 INDIANA AVE STE 130
RIVERSIDE CA
92506-4266
US

V. Phone/Fax

Practice location:
  • Phone: 951-444-8077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: