Provider Demographics
NPI:1518387653
Name:PAZOS, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PAZOS
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 1:6711 FIVE STAR BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2678
Mailing Address - Country:US
Mailing Address - Phone:916-532-5001
Mailing Address - Fax:
Practice Address - Street 1:6711 FIVE STAR BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2678
Practice Address - Country:US
Practice Address - Phone:916-532-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist