Provider Demographics
NPI:1275857997
Name:RUELAS, MELISA A
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:A
Last Name:RUELAS
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 1:27710 JEFFERSON AVE
Mailing Address - Street 2:STE. 205
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4604
Mailing Address - Country:US
Mailing Address - Phone:951-956-1127
Mailing Address - Fax:
Practice Address - Street 1:27710 JEFFERSON AVE
Practice Address - Street 2:STE. 205
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4604
Practice Address - Country:US
Practice Address - Phone:951-956-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health