Provider Demographics
NPI:1982966610
Name:LEGERE, MELISSA FRANCES (LMFT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:FRANCES
Last Name:LEGERE
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:PO BOX 893953
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92589-3953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41890 ENTERPRISE CIR S
Practice Address - Street 2:SUITE 297
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4819
Practice Address - Country:US
Practice Address - Phone:951-764-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC51286106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist