Healthcare Provider Details

I. General information

NPI: 1932444056
Provider Name (Legal Business Name): MELANIE J CAUBLE MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 COLEMAN AVE STE F23
SANTA CLARA CA
95050-4359
US

IV. Provider business mailing address

10561 30TH AVE NE
SEATTLE WA
98125-7947
US

V. Phone/Fax

Practice location:
  • Phone: 408-418-6638
  • Fax:
Mailing address:
  • Phone: 408-365-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC52489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: