MEDICARE: CLAUDIA MELO LMFT

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	106H00000X	Marriage & Family Therapist	IMFT69192	CA
2	106H00000X	Marriage & Family Therapist	100779	CA

General Provider Information

NPI Number	:	1780713677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA MELO LMFT

Provider Business Mailing Address
First Line	:	PO BOX 50695
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91115-0695
Country	:	US
Telephone Number	:	626-826-0229
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6070
Country	:	US
Telephone Number	:	323-783-2600
Fax Number	:	323-783-0323

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	12/13/2021

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