Provider Demographics
NPI:1326912643
Name:CARLSON, ANNA MOSHELLE (MS, PPC)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MOSHELLE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MS, PPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SOMMERVILLE PL
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0240
Mailing Address - Country:US
Mailing Address - Phone:949-586-1234
Mailing Address - Fax:
Practice Address - Street 1:1 TORINO
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2208
Practice Address - Country:US
Practice Address - Phone:949-470-4885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool