Provider Demographics
NPI:1093282832
Name:MELENDREZ, CHELSEA J
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:J
Last Name:MELENDREZ
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 1:9080 BLOOMFIELD AVE SPC 106
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-6964
Mailing Address - Country:US
Mailing Address - Phone:714-365-1500
Mailing Address - Fax:
Practice Address - Street 1:9844 RESEARCH DR STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4381
Practice Address - Country:US
Practice Address - Phone:760-815-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health