Provider Demographics
NPI:1518523489
Name:LIPARI, MELISSA LYNN (DPM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:LIPARI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 MERCY CT STE 260
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3190
Mailing Address - Country:US
Mailing Address - Phone:916-961-3434
Mailing Address - Fax:
Practice Address - Street 1:6600 MERCY CT STE 260
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3190
Practice Address - Country:US
Practice Address - Phone:916-961-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE6086213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program