Healthcare Provider Details

I. General information

NPI: 1073358339
Provider Name (Legal Business Name): MELISSA C NOEL I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S LAKE AVE
PASADENA CA
91101-3005
US

IV. Provider business mailing address

12459 LEWIS ST STE 201
GARDEN GROVE CA
92840-6606
US

V. Phone/Fax

Practice location:
  • Phone: 626-432-7270
  • Fax:
Mailing address:
  • Phone: 800-249-1266
  • Fax: 800-385-8191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: