Provider Demographics
NPI:1871032144
Name:MELISSA GRANCHI
Entity Type:Organization
Organization Name:MELISSA GRANCHI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MFC
Authorized Official - Phone:916-743-6556
Mailing Address - Street 1:19405 DEERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VOLCANO
Mailing Address - State:CA
Mailing Address - Zip Code:95689-9771
Mailing Address - Country:US
Mailing Address - Phone:916-743-6556
Mailing Address - Fax:
Practice Address - Street 1:19405 DEERWOOD DR
Practice Address - Street 2:
Practice Address - City:VOLCANO
Practice Address - State:CA
Practice Address - Zip Code:95689-9771
Practice Address - Country:US
Practice Address - Phone:916-743-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-19
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51498251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management