Provider Demographics
NPI:1265756803
Name:CANTEKIN, MELISSA JONES (PHD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JONES
Last Name:CANTEKIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 STATE STREET
Mailing Address - Street 2:SUITE 3-G
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6752
Mailing Address - Country:US
Mailing Address - Phone:805-965-9508
Mailing Address - Fax:
Practice Address - Street 1:1129 STATE STREET
Practice Address - Street 2:SUITE 3-G
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6752
Practice Address - Country:US
Practice Address - Phone:805-965-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAPSY#22622103TC1900X, 103TH0004X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy