Provider Demographics
NPI:1669679130
Name:PRZEKLASA AUTH, MELISSA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JOY
Last Name:PRZEKLASA AUTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:JOY
Other - Last Name:PRZEKLASA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:30131 TOWN CENTER DR
Mailing Address - Street 2:195
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2034
Mailing Address - Country:US
Mailing Address - Phone:949-495-6100
Mailing Address - Fax:949-354-0612
Practice Address - Street 1:30131 TOWN CENTER DR
Practice Address - Street 2:195
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2034
Practice Address - Country:US
Practice Address - Phone:949-495-6100
Practice Address - Fax:949-354-0612
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA941292084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology