Healthcare Provider Details

I. General information

NPI: 1770117533
Provider Name (Legal Business Name): MELANIE ANNE WELLS ACSW#125971
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31165 TEMECULA PKWY STE 368
TEMECULA CA
92592-2908
US

IV. Provider business mailing address

31165 TEMECULA PKWY STE 368
TEMECULA CA
92592-2908
US

V. Phone/Fax

Practice location:
  • Phone: 951-595-7443
  • Fax:
Mailing address:
  • Phone: 951-595-7443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125971
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: