Provider Demographics
NPI:1437334653
Name:CARREON, ISAAC (MFT)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:CARREON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5838 FORT STANWIX ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-5113
Mailing Address - Country:US
Mailing Address - Phone:951-900-3034
Mailing Address - Fax:951-344-8293
Practice Address - Street 1:19179 BLANCO RD STE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4009
Practice Address - Country:US
Practice Address - Phone:951-900-3034
Practice Address - Fax:951-344-8293
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47440106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist