Provider Demographics
NPI:1629020409
Name:LLABRES, MELISSA SUSAN DAVIS (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:SUSAN DAVIS
Last Name:LLABRES
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:SUSAN DAVIS
Other - Last Name:KALB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 9TH ST
Mailing Address - Street 2:ROOM 205 MAILSTOP 2-3
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-6414
Mailing Address - Country:US
Mailing Address - Phone:916-654-2431
Mailing Address - Fax:916-654-3186
Practice Address - Street 1:3500 ZANKER ROAD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-2299
Practice Address - Country:US
Practice Address - Phone:408-451-6198
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19791103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist