Provider Demographics
NPI:1740519289
Name:MELGAREJO, KARA JEANNINE (LMFT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:JEANNINE
Last Name:MELGAREJO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3542
Mailing Address - Country:US
Mailing Address - Phone:818-321-4613
Mailing Address - Fax:
Practice Address - Street 1:402 W BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3542
Practice Address - Country:US
Practice Address - Phone:888-874-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist