Provider Demographics
NPI:1255650693
Name:GARCIA, MELISSA R
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:R
Last Name:GARCIA
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 1:260 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6216
Mailing Address - Country:US
Mailing Address - Phone:209-381-1135
Mailing Address - Fax:209-381-1173
Practice Address - Street 1:260 E 15TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6216
Practice Address - Country:US
Practice Address - Phone:209-381-1135
Practice Address - Fax:209-381-1173
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker