Individual
MS. INGRID LISSETTE PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4075 NIELSON RD, PHELAN, CA 92371-8896
(760) 868-5817
Mailing address
4075 NIELSON RD, PHELAN, CA 92371-8896
(760) 868-5817
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041S0200X
School Social Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/26/2017
Last updated
08/27/2025
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