Provider Demographics
NPI:1255811006
Name:CHAVEZ, MELISSA (MSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 JOHN JONES RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-9701
Mailing Address - Country:US
Mailing Address - Phone:530-758-5305
Mailing Address - Fax:530-758-8490
Practice Address - Street 1:2051 JOHN JONES RD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-9701
Practice Address - Country:US
Practice Address - Phone:530-758-2060
Practice Address - Fax:530-758-8490
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67988104100000X
CA103617104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker