Healthcare Provider Details

I. General information

NPI: 1497378293
Provider Name (Legal Business Name): MELISSA SUE DAOUD MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30669 UNION CITY BLVD
UNION CITY CA
94587-2546
US

IV. Provider business mailing address

1050 KIELY BLVD UNIT 3207
SANTA CLARA CA
95055-5049
US

V. Phone/Fax

Practice location:
  • Phone: 855-554-2545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: