Provider Demographics
NPI:1063675387
Name:APPLEBY, MELINDA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:APPLEBY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4088 BRIDGE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7144
Mailing Address - Country:US
Mailing Address - Phone:916-287-1926
Mailing Address - Fax:916-967-1042
Practice Address - Street 1:4088 BRIDGE ST STE 3
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7144
Practice Address - Country:US
Practice Address - Phone:916-287-1926
Practice Address - Fax:916-967-1042
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY26171103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health