Provider Demographics
NPI:1760219596
Name:ADKINS, MELISSA (MA, EDS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:MA, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14121 CEDARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4499
Mailing Address - Country:US
Mailing Address - Phone:714-894-7311
Mailing Address - Fax:
Practice Address - Street 1:13603 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3006
Practice Address - Country:US
Practice Address - Phone:714-894-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool