Provider Demographics
NPI:1245573823
Name:BYERS, MELANIE A
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:A
Last Name:BYERS
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 1:15 S LAKE DR
Mailing Address - Street 2:APT A-2
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-2007
Mailing Address - Country:US
Mailing Address - Phone:925-864-2775
Mailing Address - Fax:
Practice Address - Street 1:1251 CALIFORNIA AVE
Practice Address - Street 2:STE 600
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4181
Practice Address - Country:US
Practice Address - Phone:925-439-5161
Practice Address - Fax:925-439-0322
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3545-R101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)