Provider Demographics
NPI:1134695414
Name:BOJORQUEZ-GONZALEZ, MELISSA ELIZABETH LEE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ELIZABETH LEE
Last Name:BOJORQUEZ-GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:ELIZABETH
Other - Last Name:BOJORQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:401 S ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-6919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 S ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-6919
Practice Address - Country:US
Practice Address - Phone:310-221-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator