Provider Demographics
NPI:1821402090
Name:AFSHAR, MELANIE (PSYD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:AFSHAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:AFSHAR-CANCINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:62 DISCOVERY STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3143
Mailing Address - Country:US
Mailing Address - Phone:949-299-5441
Mailing Address - Fax:
Practice Address - Street 1:62 DISCOVERY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3142
Practice Address - Country:US
Practice Address - Phone:949-351-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659500569OtherORANGE COUNTY HEALTH & PSYCHOLOGY ASSOCIATES