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General NPI Number Information
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NPI Number | 1295055044
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Entity Type | Individual
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Provider Name | MELISSA ANN GIBSON LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3050 CHICAGO AVE STE 180
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City | RIVERSIDE
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State | CA
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Zip | 92507-3418
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Country | US
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Telephone | 951-686-8500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 906
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City | CATHEDRAL CITY
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State | CA
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Zip | 92235-0906
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 153097
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 153097
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License Number State | CA
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