Provider Demographics
NPI:1326345620
Name:FOLEY, MELISSA ANNE
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:FOLEY
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 1:1196 E LASSEN AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0892
Mailing Address - Country:US
Mailing Address - Phone:530-879-2456
Mailing Address - Fax:530-879-3932
Practice Address - Street 1:1196 E LASSEN AVE STE 130
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0892
Practice Address - Country:US
Practice Address - Phone:530-879-2456
Practice Address - Fax:530-879-3932
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364291041C0700X
171M00000X
CA823141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator