Provider Demographics
NPI:1689906711
Name:GASTELLUM, MELISSA KRISTINA (ND)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:KRISTINA
Last Name:GASTELLUM
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1839B YGNACIO VALLEY ROAD
Mailing Address - Street 2:#393
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:510-593-3751
Mailing Address - Fax:
Practice Address - Street 1:120 LA CASA VIA STE 104
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3094
Practice Address - Country:US
Practice Address - Phone:925-939-0300
Practice Address - Fax:925-939-3181
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND384175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath