Provider Demographics
NPI:1215185392
Name:MORAIS PARR, MELISSA JAYNES
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JAYNES
Last Name:MORAIS PARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JAYNES
Other - Last Name:MORAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 131192
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92013-1192
Mailing Address - Country:US
Mailing Address - Phone:858-367-0821
Mailing Address - Fax:
Practice Address - Street 1:1043 VIA VERA CRUZ
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078
Practice Address - Country:US
Practice Address - Phone:858-367-0821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52656106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist