Healthcare Provider Details

I. General information

NPI: 1477083418
Provider Name (Legal Business Name): MELODY VUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 FRANKLIN BLVD
SACRAMENTO CA
95823-1820
US

IV. Provider business mailing address

8021 WHITE CASTLE WAY
SACRAMENTO CA
95828-5446
US

V. Phone/Fax

Practice location:
  • Phone: 916-388-9418
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: