Provider Demographics
NPI:1407550726
Name:ATHERTON, MELISSA JOY
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JOY
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:JOY
Other - Last Name:LANDRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 DEVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1913
Mailing Address - Country:US
Mailing Address - Phone:423-653-8122
Mailing Address - Fax:
Practice Address - Street 1:8767 CARMEL VALLEY RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-7958
Practice Address - Country:US
Practice Address - Phone:831-582-1017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health