Provider Demographics
NPI:1003919564
Name:MELONE, BARBARA DIANE (MFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:DIANE
Last Name:MELONE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:DIANE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:579 LATIMER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008
Mailing Address - Country:US
Mailing Address - Phone:408-866-7946
Mailing Address - Fax:
Practice Address - Street 1:579 LATIMER CIRCLE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008
Practice Address - Country:US
Practice Address - Phone:408-866-7946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTF30574106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist