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General NPI Number Information
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NPI Number | 1477722726
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Entity Type | Individual
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Provider Name | CARMELO ISALES JR. PSY.D LMFT
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Gender | Male
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 29970 TECHNOLOGY DR STE 105B
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City | MURRIETA
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State | CA
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Zip | 92563-2646
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Country | US
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Telephone | 951-970-7935
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Fax | 877-755-4903
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Provider Business Mailing Address
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Address Line | 29384 MASTERS DR
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City | MURRIETA
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State | CA
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Zip | 92563-5855
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Country | US
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Telephone | 951-970-7935
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Fax | 877-755-4903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 42219
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License Number State | CA
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