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General NPI Number Information
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NPI Number | 1184299943
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Entity Type | Individual
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Provider Name | BERTHA MELENDEZ
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Gender | Female
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 1234 W CHAPMAN AVE STE 205
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City | ORANGE
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State | CA
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Zip | 92868-2863
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Country | US
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Telephone | 714-639-1815
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Fax |
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Provider Business Mailing Address
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Address Line | 4437 OWENS ST UNIT 105
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City | CORONA
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State | CA
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Zip | 92883-7396
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Country | US
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Telephone | 714-262-3596
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95016742
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License Number State | CA
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