Melissa Marie Ellena Carmona, M.S., LMFT

Key facts

NPI

1265809669

Entity type

Individual (NPI type 1)

Primary specialty

Marriage & Family Therapist 106H00000X

License

106542 (CA)

Practice address

36896 Pebley CT
Winchester, CA 92596-8928

Phone

(760) 780-7242

NPI assigned

Sep 1, 2015

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 25, 2025.

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1265809669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36896 PEBLEY CT",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968928",
            "telephone_number": "760-780-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36896 PEBLEY CT",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968928",
            "telephone_number": "760-780-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "MELISSA",
        "middle_name": "MARIE ELLENA",
        "credential": "M.S., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "106542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE AND FAMILY THERAPY INTERN",
            "identifier": "77543",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MARRIAGE AND FAMILY THERAPIST",
            "identifier": "106542",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Winchester, CA · Marriage & Family Therapist in California