Provider Demographics
NPI:1730551615
Name:PERCY, MELISSA MILNE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MILNE
Last Name:PERCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MILNE
Other - Last Name:OGATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2206 N WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7161
Mailing Address - Country:US
Mailing Address - Phone:714-306-1000
Mailing Address - Fax:
Practice Address - Street 1:2206 N WRIGHT ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-7161
Practice Address - Country:US
Practice Address - Phone:714-306-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW194701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical