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General NPI Number Information
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NPI Number | 1922423581
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Entity Type | Individual
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Provider Name | MS. MELISSA ELIZABETH JEFFERSON
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Gender | Female
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-268-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 2321 N NIAGARA ST APT D
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City | BURBANK
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State | CA
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Zip | 91504-3258
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Country | US
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Telephone | 818-903-7038
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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 | 2278G1100X
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Taxonomy Name | General Care Certified Respiratory Therapist
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License Number | 16263
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License Number State | CA
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