Healthcare Provider Details

I. General information

NPI: 1679032965
Provider Name (Legal Business Name): MELINA GIPSON M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2019
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 N ORANGE ST STE 200
ORANGE CA
92866-1430
US

IV. Provider business mailing address

191 N ORANGE ST STE 200
ORANGE CA
92866-1430
US

V. Phone/Fax

Practice location:
  • Phone: 909-557-5577
  • Fax:
Mailing address:
  • Phone: 909-557-5577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number1482460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: