Provider Demographics
NPI:1881912301
Name:STOLSIG, MELISSA S (MS, MA, PSYD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:S
Last Name:STOLSIG
Suffix:
Gender:F
Credentials:MS, MA, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 21ST ST STE 4262
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5226
Mailing Address - Country:US
Mailing Address - Phone:805-910-7455
Mailing Address - Fax:805-910-7455
Practice Address - Street 1:1401 21ST ST STE 4262
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5226
Practice Address - Country:US
Practice Address - Phone:805-910-7455
Practice Address - Fax:805-910-7455
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30738103T00000X, 103TA0400X, 103TA0700X, 103TC2200X, 103TH0004X, 103TC0700X, 103TC0700X
COPSY.0005510103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth