Provider Demographics
NPI:1659612182
Name:THOMAS, MELISSA ANNE (DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MELROSE DR STE 215
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6632
Mailing Address - Country:US
Mailing Address - Phone:760-509-9901
Mailing Address - Fax:760-509-9902
Practice Address - Street 1:400 S MELROSE DR STE 215
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6632
Practice Address - Country:US
Practice Address - Phone:760-509-9901
Practice Address - Fax:760-509-9902
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist