MEDICARE: MELISSA CAINE-HUCKABAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1083896484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA CAINE-HUCKABAY

Provider Business Mailing Address
First Line	:	2101 VAN NESS ST
Second Line	:
City	:	SAN PABLO
State	:	CA
Zip	:	94806-3622
Country	:	US
Telephone Number	:	510-237-0113
Fax Number	:	510-237-0177

Provider Business Practice Location Address
First Line	:	2101 VAN NESS ST
Second Line	:
City	:	SAN PABLO
State	:	CA
Zip	:	94806-3622
Country	:	US
Telephone Number	:	510-237-0113
Fax Number	:	510-237-0177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	11/28/2007

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Directions to “ MELISSA CAINE-HUCKABAY ” Practice Location

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