Provider Demographics
NPI:1497438279
Name:CAISSY, MELISSA R
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:R
Last Name:CAISSY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W SASAKI AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-3980
Mailing Address - Country:US
Mailing Address - Phone:339-225-1171
Mailing Address - Fax:
Practice Address - Street 1:1300 E SHAW AVE STE 149
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7903
Practice Address - Country:US
Practice Address - Phone:559-554-9710
Practice Address - Fax:559-554-9710
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist