Individual provider Active NPI

Melissa Marie Ellena Carmona, M.S., LMFT

  • Marriage & Family Therapist
  • Winchester, CA
National Provider Identifier
1265809669
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
106542 Issued in CA
Practice address
36896 Pebley CT
Winchester, CA 92596-8928
Phone
(760) 780-7242
NPI assigned
Sep 1, 2015
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 106542 CA Primary

Addresses

Primary practice location

36896 Pebley CT
Winchester, CA 92596-8928

Mailing address

36896 Pebley CT
Winchester, CA 92596-8928
Phone (760) 780-7242

Other identifiers 2

IdentifierTypeStateIssuer
77543OtherCAMARRIAGE AND FAMILY THERAPY INTERN
106542OtherCALICENSED MARRIAGE AND FAMILY THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
106542CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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": []
}

Other providers in Winchester, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.