Provider Demographics
NPI:1316179377
Name:MOTOMURA, MELASON RAKSHA
Entity Type:Individual
Prefix:
First Name:MELASON
Middle Name:RAKSHA
Last Name:MOTOMURA
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 1:2500 N TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-1639
Mailing Address - Country:US
Mailing Address - Phone:707-428-4198
Mailing Address - Fax:
Practice Address - Street 1:2500 N TEXAS ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-1639
Practice Address - Country:US
Practice Address - Phone:707-428-4198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker