Provider Demographics
NPI:1376706044
Name:HUSS, MELITA (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:MELITA
Middle Name:
Last Name:HUSS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:MRS
Other - First Name:MELITA
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9029 JAMACHA RD
Mailing Address - Street 2:APT 74
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-4177
Mailing Address - Country:US
Mailing Address - Phone:619-993-0286
Mailing Address - Fax:
Practice Address - Street 1:9029 JAMACHA RD
Practice Address - Street 2:APT 74
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-4177
Practice Address - Country:US
Practice Address - Phone:619-993-0286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH 1101183700000X
CA410101070961202183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician