Sergio Islas

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

155501 Issued in CA

Practice address

17800 US Highway 18
Apple Valley, CA 92307-1221

Phone

(760) 242-6336

Fax

(760) 946-0819

NPI assigned

May 19, 2011

Last updated

Jun 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Bernardino County Superintendent of Schools

  • Community/Behavioral Health Agency
  • Apple Valley, CA
  • NPI 1518091966
  NPD (past)

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1457644783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071221",
            "telephone_number": "760-242-6336",
            "fax_number": "760-946-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071221",
            "telephone_number": "760-242-6336",
            "fax_number": "760-946-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAS",
        "first_name": "SERGIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "155501",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE AND FAMILY THERAPIST INTERN",
            "identifier": "IMF 74045",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Interim Healthcare of Riverside, Inc.
• Interim Homestyle Services, Inc.
• Interventional Radiation Oncology of California Inc
• Cameron Ali Irshaid
• Kevork Iskenderian, M.D.
• Shurouk I Ismail, MD
• Amanda Leigh Jackson
• Andre Nakromba Jackson, MFTI
• Bruce L Jackson, P.A.
• Daysia Jackson

• Marriage & Family Therapist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.