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General NPI Number Information
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NPI Number | 1972940286
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Entity Type | Individual
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Provider Name | MELISSA JEAN MICHAELS MFTI, 73433
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Gender | Female
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 16944 VENTURA BLVD SUITE 24
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City | ENCINO
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State | CA
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Zip | 91316-4144
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Country | US
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Telephone | 818-745-2515
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Fax | 818-691-2377
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Provider Business Mailing Address
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Address Line | 2460 MAIN ST
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City | MORRO BAY
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State | CA
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Zip | 93442-1552
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Country | US
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Telephone | 805-772-2212
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Fax | 805-771-9620
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 73433
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License Number State | CA
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