Provider Demographics
NPI:1730551813
Name:JAGGERS, MELINDA
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:JAGGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-1869
Mailing Address - Country:US
Mailing Address - Phone:530-229-8043
Mailing Address - Fax:
Practice Address - Street 1:3650 LAKE FOREST DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-1869
Practice Address - Country:US
Practice Address - Phone:530-229-8043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator