Provider Demographics
NPI:1093542979
Name:DEMELLO, JOELLE
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:DEMELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4898 MALIBU DR
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1710
Mailing Address - Country:US
Mailing Address - Phone:530-525-2211
Mailing Address - Fax:
Practice Address - Street 1:4129 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1848
Practice Address - Country:US
Practice Address - Phone:805-964-4795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)