Provider Demographics
NPI:1619580396
Name:ZAVALA, MELISSA
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:ZAVALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65278 DONOVAN CIR
Mailing Address - Street 2:
Mailing Address - City:MECCA
Mailing Address - State:CA
Mailing Address - Zip Code:92254-7226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65278 DONOVAN CIR
Practice Address - Street 2:
Practice Address - City:MECCA
Practice Address - State:CA
Practice Address - Zip Code:92254-7226
Practice Address - Country:US
Practice Address - Phone:760-863-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist