Organization
PRISM FAMILY COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMELO ISALES PSY.D (CEO)
(951) 206-7545
Entity
Organization
Contact information
Practice address
206 AVOCADO AVE. SUITE 103, PERRIS, CA 92571
(951) 206-7545
Mailing address
29384 MASTERS DR, MURRIETA, CA 92563-5855
(951) 206-7545
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
LCS 11045
CA
305R00000X
Preferred Provider Organization
Primary
MFT 42219
CA
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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