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General NPI Number Information
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NPI Number | 1104785476
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Entity Type | Individual
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Provider Name | MELINDA TUDOR
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Gender |
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 27555 YNEZ RD STE 310
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City | TEMECULA
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State | CA
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Zip | 92591-4678
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Country | US
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Telephone | 951-717-8919
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Fax |
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Provider Business Mailing Address
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Address Line | 22365 BARTON RD STE 104
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5037
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Country | US
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Telephone | 909-824-2899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 266
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License Number State | CA
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