Healthcare Provider Details

I. General information

NPI: 1831878263
Provider Name (Legal Business Name): MELISSA ANN SCAGNELLI ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 LAS VIRGENES RD STE 202
CALABASAS CA
91302-1956
US

IV. Provider business mailing address

4505 LAS VIRGENES RD STE 202
CALABASAS CA
91302-1956
US

V. Phone/Fax

Practice location:
  • Phone: 818-880-0800
  • Fax: 818-697-8766
Mailing address:
  • Phone: 818-880-0800
  • Fax: 818-697-8766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112729
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: