Healthcare Provider Details

I. General information

NPI: 1194637199
Provider Name (Legal Business Name): MELISSA LYNN CASSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 KNAPP ST
YREKA CA
96097-2365
US

IV. Provider business mailing address

431 KNAPP ST
YREKA CA
96097-2365
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-2521
  • Fax: 530-842-1759
Mailing address:
  • Phone: 530-842-2521
  • Fax: 530-842-1759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number780736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: