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General NPI Number Information
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NPI Number | 1124999214
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Entity Type | Organization
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Legal Business Name | MELANIN YOUTH FOUNDATION
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Dates
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Enumeration Date | 09/13/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 21550 LANE ST
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City | PERRIS
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State | CA
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Zip | 92570-8140
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Country | US
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Telephone | 951-712-5031
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Fax |
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Provider Business Mailing Address
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Address Line | 19510 VAN BUREN BLVD. STE F3 PMB 152
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City | RIVERSIDE
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State | CA
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Zip | 92508-9458
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Country | US
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Telephone | 951-712-5031
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRYSTAL MELESSIA SINGH
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Credential |
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Telephone | 951-712-5031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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