Provider Demographics
NPI:1265845432
Name:MELENDEZ, DARLENE REBECCA
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:REBECCA
Last Name:MELENDEZ
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 1:345 CALLE ALCAZAR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1615
Mailing Address - Country:US
Mailing Address - Phone:714-290-4375
Mailing Address - Fax:
Practice Address - Street 1:345 CALLE ALCAZAR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1615
Practice Address - Country:US
Practice Address - Phone:714-290-4375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist