Provider Demographics
NPI:1295316842
Name:JIN, MELISSA JIAO JIAO (DNP)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JIAO JIAO
Last Name:JIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:JIAO JIAO
Other - Middle Name:
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 JOHNSTONE DR APT 301
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1186
Mailing Address - Country:US
Mailing Address - Phone:818-648-0695
Mailing Address - Fax:
Practice Address - Street 1:45 JOHNSTONE DR APT 301
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-1186
Practice Address - Country:US
Practice Address - Phone:818-648-0695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017128363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner