Healthcare Provider Details

I. General information

NPI: 1205701117
Provider Name (Legal Business Name): KAREN MELERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2301 BLACK RD
SANTA MARIA CA
93455-5416
US

IV. Provider business mailing address

2301 BLACK RD
SANTA MARIA CA
93455-5416
US

V. Phone/Fax

Practice location:
  • Phone: 805-554-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95153001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: