Provider Demographics
NPI:1700810298
Name:BARBER, MELISSA ERIN (MS CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ERIN
Last Name:BARBER
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ERIN
Other - Last Name:GILLINGHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19403 VICTORY BLVD
Mailing Address - Street 2:SUITE 23
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6611
Mailing Address - Country:US
Mailing Address - Phone:818-343-8116
Mailing Address - Fax:818-343-7170
Practice Address - Street 1:5800 SANTA ROSA RD STE 123
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-7060
Practice Address - Country:US
Practice Address - Phone:805-482-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 2043231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAU2043AMedicare PIN
CAWAU2043CMedicare PIN
CAWAU2043BMedicare PIN