Provider Demographics
NPI:1184021859
Name:MATTEY, MELISSA (LM, CPM)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MATTEY
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16675 WESTFIELD LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3690
Mailing Address - Country:US
Mailing Address - Phone:918-221-1825
Mailing Address - Fax:714-406-1885
Practice Address - Street 1:16675 WESTFIELD LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-3690
Practice Address - Country:US
Practice Address - Phone:918-221-1825
Practice Address - Fax:714-406-1885
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife