Provider Demographics
NPI:1497990790
Name:ROBINSON, MELISSA ANN (MS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23283
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-0283
Mailing Address - Country:US
Mailing Address - Phone:925-984-1334
Mailing Address - Fax:
Practice Address - Street 1:130 E LELAND RD
Practice Address - Street 2:SUITE C
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4983
Practice Address - Country:US
Practice Address - Phone:925-984-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist