Provider Demographics
NPI:1013747807
Name:GAVILANES, MELISSA GABRIELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:GABRIELLE
Last Name:GAVILANES
Suffix:
Gender:F
Credentials:PSYD
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Other - First Name:
Other - Middle Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 KESTER AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-4059
Mailing Address - Country:US
Mailing Address - Phone:818-687-6005
Mailing Address - Fax:
Practice Address - Street 1:221 WESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-4103
Practice Address - Country:US
Practice Address - Phone:310-825-0768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling