MEDICARE: DR. MELANIE SUMMERHAYES PSY.D

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	103G00000X	Clinical Neuropsychologist	32252	CA
2	103TC0700X	Clinical Psychologist	32252	CA

General Provider Information

NPI Number	:	1851621650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE SUMMERHAYES PSY.D

Provider Business Mailing Address
First Line	:	501 MAIN ST STE F-217
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-8106
Country	:	US
Telephone Number	:	949-408-5712
Fax Number	:

Provider Business Practice Location Address
First Line	:	18811 HUNTINGTON ST STE 200
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6003
Country	:	US
Telephone Number	:	510-838-2242
Fax Number	:	628-243-5703

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

Provider Enumeration Date	:	12/30/2009
Last Update Date	:	05/16/2025

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