Provider Demographics
NPI:1376166256
Name:ARDELEAN, MELISSA (MS)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:ARDELEAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MEL
Other - Middle Name:
Other - Last Name:ARDELEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:7400 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-5534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8912 VOLUNTEER LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3221
Practice Address - Country:US
Practice Address - Phone:916-344-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health