MEDICARE: MELISSA ANN TOVAAS

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	104100000X	Social Worker
2	390200000X	Student in an Organized Health Care Education/Training Program
3	101YM0800X	Mental Health Counselor
4	1041C0700X	Clinical Social Worker	125825	CA

General Provider Information

NPI Number	:	1750733846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN TOVAAS

Provider Business Mailing Address
First Line	:	540 E BETTERAVIA RD STE D
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-8808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 E COLORADO BLVD STE 180&2ND
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-6143
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:	929-596-7897

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

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	06/30/2026

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