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NPI Code Detail

MEDICARE: MELIDA NOVOA ACSW

MEDICARE: MELIDA NOVOA ACSW
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
31041C0700XClinical Social Worker97022CA

General Provider Information

NPI Number : 1649558032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELIDA NOVOA ACSW
Provider Business Mailing Address
First Line : 3601 CALLE TECATE STE 201
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5056
Country : US
Telephone Number : 805-289-0120
Fax Number :
Provider Business Practice Location Address
First Line : 3601 CALLE TECATE STE 201
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5056
Country : US
Telephone Number : 805-289-0120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2011
Last Update Date : 11/01/2023

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