Healthcare Provider Details

I. General information

NPI: 1790466209
Provider Name (Legal Business Name): MELINDA CHANG MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OLD SAN FRANCISCO RD
SUNNYVALE CA
94086-6386
US

IV. Provider business mailing address

301 OLD SAN FRANCISCO RD
SUNNYVALE CA
94086-6386
US

V. Phone/Fax

Practice location:
  • Phone: 408-730-6145
  • Fax:
Mailing address:
  • Phone: 408-730-6145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC001824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: