=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770878480
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORLINA MELENDEZ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2011
-----------------------------------------------------
Last Update Date | 07/20/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1450 N TUSTIN AVE STE 201
-----------------------------------------------------
City | SANTA ANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92705-8642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-295-4855
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 6635
-----------------------------------------------------
City | HUNTINGTON BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92615-6635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-295-4855
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST
-----------------------------------------------------
Name | ORLINA MELENDEZ
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 949-295-4855
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------