Healthcare Provider Details

I. General information

NPI: 1285252544
Provider Name (Legal Business Name): SARAH MELZER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 W HILLCREST DR STE 100
THOUSAND OAKS CA
91360-7820
US

IV. Provider business mailing address

4097 PINE HOLLOW PL
MOORPARK CA
93021-3122
US

V. Phone/Fax

Practice location:
  • Phone: 805-497-7888
  • Fax:
Mailing address:
  • Phone: 858-472-9446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95014703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: