Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ilissa Banhazl, MFT

Individual provider Marriage & Family Therapist · NPI 1528891777

Ilissa Banhazl, MFT is a Marriage & Family Therapist in Glendora, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024
What do these letters mean?
MFT — Marriage and Family Therapist
A therapist who treats couples and families.

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Practice location Address checks out

240 Crescent Glen Dr
Glendora, CA 91741-4016
Phone: (626) 664-5924
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 44737 (CA)

Record details

NPI number1528891777
Entity typeIndividual (Type 1)
GenderFemale
Credentials MFT
Sole proprietorYes
NPI enumeratedAugust 22, 2024
Last updated in NPPESAugust 22, 2024
Certification dateAugust 22, 2024
Mailing address240 Crescent Glen Dr, Glendora, CA 91741-4016

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