Healthcare Provider Details

I. General information

NPI: 1245824325
Provider Name (Legal Business Name): MELISSA ANNE YUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10929 SOUTH STREET SUITE 208B
CERRITOS CA
90703
US

IV. Provider business mailing address

10929 SOUTH STREET SUITE 208B
CERRITOS CA
90703
US

V. Phone/Fax

Practice location:
  • Phone: 562-924-5526
  • Fax: 564-924-1040
Mailing address:
  • Phone: 562-924-5526
  • Fax: 564-924-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: