Provider Demographics
NPI:1437413226
Name:SCHULZ, MELISSA JOAN (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JOAN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:JOAN
Other - Last Name:DRAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3445 LITTLE CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2914
Mailing Address - Country:US
Mailing Address - Phone:510-629-1246
Mailing Address - Fax:510-373-3715
Practice Address - Street 1:424 PENINSULA AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-1653
Practice Address - Country:US
Practice Address - Phone:800-538-8365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1096412103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst