Healthcare Provider Details

I. General information

NPI: 1396526240
Provider Name (Legal Business Name): MELISSA ERB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 B ST STE 2870
SAN DIEGO CA
92101-8132
US

IV. Provider business mailing address

PO BOX 18228
IRVINE CA
92623-8228
US

V. Phone/Fax

Practice location:
  • Phone: 619-722-0014
  • Fax: 619-327-4174
Mailing address:
  • Phone: 619-722-0014
  • Fax: 619-327-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: