Healthcare Provider Details

I. General information

NPI: 1407915234
Provider Name (Legal Business Name): MELISSA DEYO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 ARDEN WAY
SACRAMENTO CA
95825-3701
US

IV. Provider business mailing address

3180 ARDEN WAY
SACRAMENTO CA
95825-3701
US

V. Phone/Fax

Practice location:
  • Phone: 916-977-3277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 2097
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHA4119
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: