Provider Demographics
NPI:1043450612
Name:ANDERSON, MELISSA CURRIE (MFT, PHD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CURRIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 460216
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94146-0216
Mailing Address - Country:US
Mailing Address - Phone:510-459-9669
Mailing Address - Fax:
Practice Address - Street 1:925 THE ALAMEDA
Practice Address - Street 2:SUITE 15
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2310
Practice Address - Country:US
Practice Address - Phone:510-459-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist