Healthcare Provider Details

I. General information

NPI: 1225336696
Provider Name (Legal Business Name): MELANIE MARIE ANELLO N.P.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 HIGH SCHOOL AVE SUITE 300
CONCORD CA
94520-1800
US

IV. Provider business mailing address

PO BOX 1263
DIXON CA
95620-1263
US

V. Phone/Fax

Practice location:
  • Phone: 925-685-8894
  • Fax: 925-609-7558
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: