Healthcare Provider Details

I. General information

NPI: 1700461134
Provider Name (Legal Business Name): ALISA ARIELLE CARSTENS MARTINEZ LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISA ARIELLE CARSTENS LPCC

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 N CHERRY ST
TULARE CA
93274-2233
US

IV. Provider business mailing address

1134 E CARTMILL AVE STE C
TULARE CA
93274-9615
US

V. Phone/Fax

Practice location:
  • Phone: 559-686-9097
  • Fax: 559-556-0083
Mailing address:
  • Phone: 559-686-9097
  • Fax: 559-556-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: