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General NPI Number Information
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NPI Number | 1730817289
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Entity Type | Individual
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Provider Name | MELISSA FERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 95 3RD ST FL 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-3103
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Country | US
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Telephone | 855-832-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 4274 LAS FELIZ CT
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City | UNION CITY
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State | CA
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Zip | 94587-3813
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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