Provider Demographics
NPI:1609151653
Name:CARCHIDI, MELINDA SUZANNE
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:SUZANNE
Last Name:CARCHIDI
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 1:4204 ROCKY POINT DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6960
Mailing Address - Country:US
Mailing Address - Phone:925-922-9269
Mailing Address - Fax:
Practice Address - Street 1:4204 ROCKY POINT DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6960
Practice Address - Country:US
Practice Address - Phone:925-922-9269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program