Healthcare Provider Details

I. General information

NPI: 1619696408
Provider Name (Legal Business Name): MELISSA DIANE CHAVEZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 S K ST
TULARE CA
93274-5416
US

IV. Provider business mailing address

327 S K ST
TULARE CA
93274-5416
US

V. Phone/Fax

Practice location:
  • Phone: 559-967-0235
  • Fax:
Mailing address:
  • Phone: 559-686-9772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number157979
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: