Provider Demographics
NPI:1932513264
Name:CARPENTER-LAY, MELANEE B (LMFT)
Entity type:Individual
Prefix:
First Name:MELANEE
Middle Name:B
Last Name:CARPENTER-LAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MELANEE
Other - Middle Name:CARPENTER
Other - Last Name:SENY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:28125 BRADLEY RD STE 220
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2288
Mailing Address - Country:US
Mailing Address - Phone:951-309-2140
Mailing Address - Fax:951-309-2141
Practice Address - Street 1:28125 BRADLEY RD STE 220
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-2288
Practice Address - Country:US
Practice Address - Phone:951-893-8838
Practice Address - Fax:951-309-2141
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-14
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106476106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XMedicare UPIN