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General NPI Number Information
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NPI Number | 1467078642
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Entity Type | Individual
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Provider Name | MELISSA MARES PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3102 E HIGHLAND AVE
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City | PATTON
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State | CA
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Zip | 92369-7813
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Country | US
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Telephone | 909-672-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 3842 E 5TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90063-1503
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Country | US
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Telephone | 323-828-1776
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35562
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License Number State | CA
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