Provider Demographics
NPI:1528314358
Name:BURR, MELISSA JANE (LMFT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JANE
Last Name:BURR
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 1:717 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3708
Mailing Address - Country:US
Mailing Address - Phone:530-902-5701
Mailing Address - Fax:530-902-5701
Practice Address - Street 1:717 7TH ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-3708
Practice Address - Country:US
Practice Address - Phone:530-902-5701
Practice Address - Fax:530-902-5701
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103282106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist