Provider Demographics
NPI:1659885044
Name:MELENDEZ, ANNA KATE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:KATE
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BIRMINGHAM DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1744
Mailing Address - Country:US
Mailing Address - Phone:760-944-0563
Mailing Address - Fax:
Practice Address - Street 1:120 BIRMINGHAM DR STE 100
Practice Address - Street 2:
Practice Address - City:CARDIFF BY THE SEA
Practice Address - State:CA
Practice Address - Zip Code:92007-1744
Practice Address - Country:US
Practice Address - Phone:760-944-0563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor