Provider Demographics
NPI:1770261117
Name:ZELAYA, MELISSA JANETTE
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JANETTE
Last Name:ZELAYA
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 1:10748 CANTLAY ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-5104
Mailing Address - Country:US
Mailing Address - Phone:818-641-3460
Mailing Address - Fax:
Practice Address - Street 1:4401 CRENSHAW BLVD STE 215
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-1200
Practice Address - Country:US
Practice Address - Phone:323-291-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician