Provider Demographics
NPI:1225837230
Name:URIZAR, MELISSA (PPS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:URIZAR
Suffix:
Gender:
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6709
Mailing Address - Country:US
Mailing Address - Phone:510-914-9007
Mailing Address - Fax:
Practice Address - Street 1:3950 VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6709
Practice Address - Country:US
Practice Address - Phone:510-914-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127768106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist