Provider Demographics
NPI:1003092826
Name:MELGOZA, ALICIA
Entity Type:Individual
Prefix:MR
First Name:ALICIA
Middle Name:
Last Name:MELGOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2585
Mailing Address - Country:US
Mailing Address - Phone:530-666-8547
Mailing Address - Fax:530-661-6762
Practice Address - Street 1:14 N COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2585
Practice Address - Country:US
Practice Address - Phone:530-666-8547
Practice Address - Fax:530-661-6762
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health