Provider Demographics
NPI:1982095733
Name:MELCHOR, WESLEE SHONT'A (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:WESLEE
Middle Name:SHONT'A
Last Name:MELCHOR
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 SANTA DIANA RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-2746
Mailing Address - Country:US
Mailing Address - Phone:904-376-0024
Mailing Address - Fax:
Practice Address - Street 1:1435 SANTA DIANA RD UNIT 3
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-2746
Practice Address - Country:US
Practice Address - Phone:904-376-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704310412163W00000X
CA95035207363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse