Healthcare Provider Details

I. General information

NPI: 1285018598
Provider Name (Legal Business Name): MELISSA GONZALEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA ALTAMIRANO BCBA

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6622 N MAROA AVE
FRESNO CA
93704-1209
US

IV. Provider business mailing address

832 E CATALINA CIR
FRESNO CA
93730-0856
US

V. Phone/Fax

Practice location:
  • Phone: 559-575-8172
  • Fax: 559-575-8176
Mailing address:
  • Phone: 559-575-8172
  • Fax: 559-575-8176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-30773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: