Provider Demographics
NPI:1386846061
Name:VALDEZ RICHARDSON, MELINDA MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:MARIA
Last Name:VALDEZ RICHARDSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 WILLOW ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5216
Mailing Address - Country:US
Mailing Address - Phone:408-440-0342
Mailing Address - Fax:408-645-6470
Practice Address - Street 1:1706 WILLOW ST STE C
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5216
Practice Address - Country:US
Practice Address - Phone:408-440-0342
Practice Address - Fax:408-645-6470
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor