Healthcare Provider Details

I. General information

NPI: 1164827291
Provider Name (Legal Business Name): MELISSA LANI YALLER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA LANI MINEO LMFT

II. Dates (important events)

Enumeration Date: 10/31/2014
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR.
OXNARD CA
93036
US

IV. Provider business mailing address

530 E. LOS ANGELES AVE # 115-221
MOORPARK CA
93021
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-4233
  • Fax:
Mailing address:
  • Phone: 805-390-6062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number113712
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: