Healthcare Provider Details

I. General information

NPI: 1760219596
Provider Name (Legal Business Name): MELISSA ADKINS MA, ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13603 EDWARDS ST
WESTMINSTER CA
92683-3006
US

IV. Provider business mailing address

14121 CEDARWOOD ST
WESTMINSTER CA
92683-4499
US

V. Phone/Fax

Practice location:
  • Phone: 714-894-7244
  • Fax:
Mailing address:
  • Phone: 714-894-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: