MEDICARE: SHEREE CAPRI CARMELITA MARIE RISLEY ARAGON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	136042	CA

General Provider Information

NPI Number	:	1679429716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEREE CAPRI CARMELITA MARIE RISLEY ARAGON LCSW

Provider Business Mailing Address
First Line	:	3535 ARTHUR MACARTHUR RD
Second Line	:
City	:	SAN PEDRO
State	:	CA
Zip	:	90731-6889
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ARTHUR MACARTHUR RD
Second Line	:
City	:	SAN PEDRO
State	:	CA
Zip	:	90731-6889
Country	:	US
Telephone Number	:	505-737-9323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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