Provider Demographics
NPI:1063828697
Name:FERRER, MELODI ANN (MA)
Entity Type:Individual
Prefix:
First Name:MELODI
Middle Name:ANN
Last Name:FERRER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4935 CAMPBELL AVE
Mailing Address - Street 2:APT 8
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1609
Mailing Address - Country:US
Mailing Address - Phone:510-692-0127
Mailing Address - Fax:
Practice Address - Street 1:4935 CAMPBELL AVE
Practice Address - Street 2:APT 8
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95130-1609
Practice Address - Country:US
Practice Address - Phone:510-692-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8626235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist