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NPI Code Detail

MEDICARE: MELANNEY ELIZABETH MATIAS

MEDICARE: MELANNEY ELIZABETH MATIAS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1376289587
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANNEY ELIZABETH MATIAS
Provider Business Mailing Address
First Line : 3175 DATA DR APT 1105
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-6436
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9755 LINCOLN VILLAGE DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-3334
Country : US
Telephone Number : 916-363-6103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2022
Last Update Date : 01/09/2026

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Directions to “ MELANNEY ELIZABETH MATIAS ” Practice Location

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