MEDICARE: MELISSA PROSCH HUY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	PSY 18078	CA

General Provider Information

NPI Number	:	1922130996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELISSA PROSCH HUY

Provider Business Mailing Address
First Line	:	4700 E BRYSON ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-1901
Country	:	US
Telephone Number	:	714-936-0528
Fax Number	:	714-693-9333

Provider Business Practice Location Address
First Line	:	13 ORCHARD STE 103
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-8321
Country	:	US
Telephone Number	:	714-936-0528
Fax Number	:	714-693-9333

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MELISSA HUY
Credential	:	PH.D.
Telephone Number	:	714-936-0528

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/22/2020

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