MEDICARE: MELISSA CHAVEZ NP

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	363LP2300X	Primary Care Nurse Practitioner	1700444205	CA

General Provider Information

NPI Number	:	1700444205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA CHAVEZ NP

Provider Business Mailing Address
First Line	:	3305 DEERING ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601-2723
Country	:	US
Telephone Number	:	510-689-7576
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 NOOR AVE
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-5916
Country	:	US
Telephone Number	:	650-955-7915
Fax Number	:	650-955-7397

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

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	10/21/2025

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