Healthcare Provider Details

I. General information

NPI: 1932082799
Provider Name (Legal Business Name): MELINA VILLALPANDO PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SHASTA DR
DAVIS CA
95616-6691
US

IV. Provider business mailing address

1895 BUTTE LODGE CT
GRIDLEY CA
95948-9340
US

V. Phone/Fax

Practice location:
  • Phone: 530-747-7000
  • Fax:
Mailing address:
  • Phone: 530-933-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: