Healthcare Provider Details

I. General information

NPI: 1215847934
Provider Name (Legal Business Name): FEDERICO PARRES PSY.D & LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8088 PALM LN
SAN BERNARDINO CA
92410-4972
US

IV. Provider business mailing address

PO BOX 7663
SAN BERNARDINO CA
92411-0663
US

V. Phone/Fax

Practice location:
  • Phone: 909-241-8582
  • Fax:
Mailing address:
  • Phone: 909-242-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number15558
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number31762
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: