Provider Demographics
NPI:1538498324
Name:GARAFALO-CULMER, MELISSA ANN (AUD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:GARAFALO-CULMER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:GARAFALO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5100 ADOLFO RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-6792
Mailing Address - Country:US
Mailing Address - Phone:805-437-1380
Mailing Address - Fax:805-389-4297
Practice Address - Street 1:5100 ADOLFO RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-6792
Practice Address - Country:US
Practice Address - Phone:805-437-1380
Practice Address - Fax:805-389-4297
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD575231H00000X
CAAU2826231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76308529Medicaid
CO020615OtherKAISER COMMERCIAL NUMBER
COCO307427Medicare PIN