Provider Demographics
NPI:1841528387
Name:MELISSA SWEITZER, PH.D, INC.
Entity type:Organization
Organization Name:MELISSA SWEITZER, PH.D, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-748-4440
Mailing Address - Street 1:17853 SANTIAGO BLVD
Mailing Address - Street 2:#107-329
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:714-974-8727
Practice Address - Street 1:12443 LEWIS DR.
Practice Address - Street 2:SUITE 201
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840
Practice Address - Country:US
Practice Address - Phone:714-748-4440
Practice Address - Fax:714-748-4445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MELISSA SWEITZER, PH.D, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-04-1578103K00000X
CAPSY10740103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty