Provider Demographics
NPI:1225485147
Name:CAMPE, MELISSA CAROL (MS)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:CAROL
Last Name:CAMPE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3392 ROCKVIEW PL
Mailing Address - Street 2:APT #1
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6787
Mailing Address - Country:US
Mailing Address - Phone:661-332-6228
Mailing Address - Fax:
Practice Address - Street 1:3392 ROCKVIEW PL
Practice Address - Street 2:APT #1
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6787
Practice Address - Country:US
Practice Address - Phone:661-332-6228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92881106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist