MEDICARE: DR. MELISSA PROSCH HUY PH.D.

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	103G00000X	Clinical Neuropsychologist	PSY 18078	CA
2	103TC0700X	Clinical Psychologist	PSY18078	CA
3	103TA0700X	Adult Development & Aging Psychologist	PSY18078	CA
4	103TC2200X	Clinical Child & Adolescent Psychologist	PSY18078	CA
5	103TC1900X	Counseling Psychologist	PSY18078	CA
6	103TF0000X	Family Psychologist	PSY18978	CA
7	103TM1800X	Intellectual & Developmental Disabilities Psychologist	PSY18078	CA
8	103TP2701X	Group Psychotherapy Psychologist	PSY18078	CA

General Provider Information

NPI Number	:	1609948264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA PROSCH HUY PH.D.

Provider Business Mailing Address
First Line	:	4430 E MIRALOMA AVE STE F
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-1840
Country	:	US
Telephone Number	:	714-936-0528
Fax Number	:	714-693-9333

Provider Business Practice Location Address
First Line	:	4811 EUREKA AVE
Second Line	:	SUITE G-4
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3368
Country	:	US
Telephone Number	:	714-936-0528
Fax Number	:	714-693-9333

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	03/07/2014

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