Provider Demographics
NPI:1568040731
Name:AGUAS, MELISSA
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:AGUAS
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 1:2000 KAMMERER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-3016
Mailing Address - Country:US
Mailing Address - Phone:510-980-8950
Mailing Address - Fax:
Practice Address - Street 1:2000 KAMMERER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-3016
Practice Address - Country:US
Practice Address - Phone:510-980-8950
Practice Address - Fax:408-293-1000
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator