Provider Demographics
NPI:1467970590
Name:WINFIELD, MELISSA JOY (PSYD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOY
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S CANYON BLVD APT B
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-5921
Mailing Address - Country:US
Mailing Address - Phone:503-537-8026
Mailing Address - Fax:
Practice Address - Street 1:520 S GRAND AVE STE 671
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-2655
Practice Address - Country:US
Practice Address - Phone:323-817-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program