Healthcare Provider Details

I. General information

NPI: 1437565306
Provider Name (Legal Business Name): MELISSA GRABAU PSYCHOLOGIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 CABRILLO AVE
DAVIS CA
95616-0412
US

IV. Provider business mailing address

433 CABRILLO AVE
DAVIS CA
95616-0412
US

V. Phone/Fax

Practice location:
  • Phone: 916-743-3870
  • Fax:
Mailing address:
  • Phone: 916-743-3870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPSY17025
License Number StateCA

VIII. Authorized Official

Name: DR. MELISSA NOEL GRABAU
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 916-743-3870