Healthcare Provider Details

I. General information

NPI: 1285510750
Provider Name (Legal Business Name): MELANIE ENJILI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7934 CLEON AVE
SUN VALLEY CA
91352-4604
US

IV. Provider business mailing address

7934 CLEON AVE
SUN VALLEY CA
91352-4604
US

V. Phone/Fax

Practice location:
  • Phone: 818-821-9050
  • Fax: 818-821-9050
Mailing address:
  • Phone: 818-821-9050
  • Fax: 818-821-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: