Individual
CARISA KELSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
302 N EL CAMINO REAL STE 216, SAN CLEMENTE, CA 92672-4778
(949) 342-6520
Mailing address
302 N EL CAMINO REAL STE 216, SAN CLEMENTE, CA 92672-4778
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9684
CA
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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