MEDICARE: MS. JULIE MELENDREZ

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	RT1444150526	CA

General Provider Information

NPI Number	:	1477341659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE MELENDREZ

Provider Business Mailing Address
First Line	:	14530 SYLVAN ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2324
Country	:	US
Telephone Number	:	818-582-8832
Fax Number	:	818-582-8836

Provider Business Practice Location Address
First Line	:	14530 SYLVAN ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2324
Country	:	US
Telephone Number	:	818-582-8832
Fax Number	:	818-582-8836

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

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	05/15/2026

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