Healthcare Provider Details

I. General information

NPI: 1194394403
Provider Name (Legal Business Name): MELISSA KRISTINE PAZ-MEDRANO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 BARRANCA PKWY
IRVINE CA
92604-4698
US

IV. Provider business mailing address

5050 BARRANCA PKWY
IRVINE CA
92604-4698
US

V. Phone/Fax

Practice location:
  • Phone: 949-936-5000
  • Fax: 949-936-5259
Mailing address:
  • Phone: 949-936-5000
  • Fax: 949-936-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: