Healthcare Provider Details

I. General information

NPI: 1053894683
Provider Name (Legal Business Name): SYDNEY TAYLOR MELENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 07/20/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 5TH ST STE 658
SANTA ANA CA
92701-4599
US

IV. Provider business mailing address

405 W 5TH ST STE 658
SANTA ANA CA
92701-4599
US

V. Phone/Fax

Practice location:
  • Phone: 714-935-6117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number14344
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140736
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number14344
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number140736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: