Provider Demographics
NPI:1801126891
Name:FRENCH, MELODY (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:
Last Name:FRENCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:
Other - Last Name:HICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:11440 W. BERNARDO CT.
Mailing Address - Street 2:STE. 256
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127
Mailing Address - Country:US
Mailing Address - Phone:619-786-3111
Mailing Address - Fax:858-524-6344
Practice Address - Street 1:11440 W. BERNARDO CT.
Practice Address - Street 2:STE. 256
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127
Practice Address - Country:US
Practice Address - Phone:619-786-3111
Practice Address - Fax:858-524-6344
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPS2012110101YM0800X
NONE390200000X
CAPSY28235103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program