Provider Demographics
NPI:1629117049
Name:HAUPT, MELISSA (MFT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HAUPT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 VISTA WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-3629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3142 VISTA WAY STE 400
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-3629
Practice Address - Country:US
Practice Address - Phone:760-842-6208
Practice Address - Fax:760-529-0436
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50757106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist