Provider Demographics
NPI:1407014145
Name:JAMES, CARLISSA TOSHAWN (MFT)
Entity Type:Individual
Prefix:MS
First Name:CARLISSA
Middle Name:TOSHAWN
Last Name:JAMES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 W MARCH LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6457
Mailing Address - Country:US
Mailing Address - Phone:209-954-1311
Mailing Address - Fax:
Practice Address - Street 1:1833 W MARCH LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6457
Practice Address - Country:US
Practice Address - Phone:209-954-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist