MEDICARE: MS. ANN KRISTINA MELBY

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	175T00000X	Peer Specialist
2	247200000X	Other Technician

General Provider Information

NPI Number	:	1952608192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN KRISTINA MELBY

Provider Business Mailing Address
First Line	:	1282 MARKET ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-4801
Country	:	US
Telephone Number	:	415-579-3021
Fax Number	:

Provider Business Practice Location Address
First Line	:	1282 MARKET ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-4801
Country	:	US
Telephone Number	:	415-579-3021
Fax Number	:

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

Provider Enumeration Date	:	02/24/2011
Last Update Date	:	11/10/2025

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