Provider Demographics
NPI:1821646233
Name:MELCHER, DE ANN EILEEN
Entity Type:Individual
Prefix:
First Name:DE ANN
Middle Name:EILEEN
Last Name:MELCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 GUADALUPE MINES RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-4817
Mailing Address - Country:US
Mailing Address - Phone:408-513-4047
Mailing Address - Fax:408-268-5110
Practice Address - Street 1:6006 GUADALUPE MINES RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-4817
Practice Address - Country:US
Practice Address - Phone:408-513-4047
Practice Address - Fax:408-268-5110
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant