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General NPI Number Information
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NPI Number | 1619849239
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Entity Type | Individual
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Provider Name | MELISSA ANN HAYWARD TUCKER SPIRITUAL COUNSELOR
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Gender | Female
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 1341 W 53RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90037-3436
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Country | US
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Telephone | 310-704-8705
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Fax |
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Provider Business Mailing Address
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Address Line | 937 W ELM ST
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City | COMPTON
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State | CA
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Zip | 90220-1815
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Country | US
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Telephone | 310-482-1675
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Fax | 310-820-9805
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | CA
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