Provider Demographics
NPI:1528384369
Name:STATON, MALISSA (LMFT)
Entity Type:Individual
Prefix:
First Name:MALISSA
Middle Name:
Last Name:STATON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 MANZANITA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1358
Mailing Address - Country:US
Mailing Address - Phone:805-952-2147
Mailing Address - Fax:
Practice Address - Street 1:468 MANZANITA AVE STE 2A
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1358
Practice Address - Country:US
Practice Address - Phone:805-835-7159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health