Provider Demographics
NPI:1730355819
Name:CARLOS, MICHELLE KAY (MSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KAY
Last Name:CARLOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28032 HILLPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92585-8991
Mailing Address - Country:US
Mailing Address - Phone:951-741-8866
Mailing Address - Fax:
Practice Address - Street 1:25240 HANCOCK AVE STE 120
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5991
Practice Address - Country:US
Practice Address - Phone:951-200-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker