Provider Demographics
NPI:1164808119
Name:LEDESMA, MELANY
Entity Type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:LEDESMA
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 1:4205 W FIGARDEN DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6051
Mailing Address - Country:US
Mailing Address - Phone:559-221-1680
Mailing Address - Fax:559-221-4336
Practice Address - Street 1:1300 17TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4504
Practice Address - Country:US
Practice Address - Phone:661-852-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor