Provider Demographics
NPI:1336356914
Name:HOWARD, MELINDA (IMF)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 EL CAJON BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1293
Mailing Address - Country:US
Mailing Address - Phone:619-283-9624
Mailing Address - Fax:619-641-7656
Practice Address - Street 1:4275 EL CAJON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1293
Practice Address - Country:US
Practice Address - Phone:619-283-9624
Practice Address - Fax:619-641-7656
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF51038106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist