Provider Demographics
NPI:1730882804
Name:CRUZ, MELANIE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CRUZ
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 1:12400 VENTURA BLVD # 625
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2406
Mailing Address - Country:US
Mailing Address - Phone:323-404-6646
Mailing Address - Fax:
Practice Address - Street 1:5520 CARLTON WAY APT B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6866
Practice Address - Country:US
Practice Address - Phone:323-404-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula