Provider Demographics
NPI:1245660422
Name:MELINO, KATERINA (RN)
Entity type:Individual
Prefix:MS
First Name:KATERINA
Middle Name:
Last Name:MELINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6013
Mailing Address - Country:US
Mailing Address - Phone:415-558-5900
Mailing Address - Fax:415-558-5959
Practice Address - Street 1:90 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6013
Practice Address - Country:US
Practice Address - Phone:415-558-5900
Practice Address - Fax:415-558-5959
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA849603163W00000X
CA95000966363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse