Healthcare Provider Details

I. General information

NPI: 1639701477
Provider Name (Legal Business Name): MELISSA JENNINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 MARKET ST STE 501
SAN FRANCISCO CA
94103-1701
US

IV. Provider business mailing address

945 MARKET ST STE 501
SAN FRANCISCO CA
94103-1701
US

V. Phone/Fax

Practice location:
  • Phone: 855-442-5885
  • Fax:
Mailing address:
  • Phone: 855-442-5885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: