MEDICARE: MELISSA BETH GEDDIS 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	139115	CA

General Provider Information

NPI Number	:	1831802396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA BETH GEDDIS LMFT

Provider Business Mailing Address
First Line	:	4820 BUSINESS CENTER DR STE 220
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-1696
Country	:	US
Telephone Number	:	707-425-2289
Fax Number	:

Provider Business Practice Location Address
First Line	:	2970 CAMINO DIABLO STE 300
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94597-4001
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

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

Provider Enumeration Date	:	12/29/2022
Last Update Date	:	01/05/2026

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