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General NPI Number Information
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NPI Number | 1518502319
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Entity Type | Individual
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Provider Name | MELISSA ANNE MAXWELL PMHNP - BC
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Gender | Female
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 11/03/2024
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Provider Practice Location Address
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Address Line | 490 POST ST STE 1043
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-1301
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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Provider Business Mailing Address
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Address Line | 490 POST ST STE 1043
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-1301
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95013526
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 28200431A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71009757B
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License Number State | IN
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