Provider Demographics
NPI:1275344822
Name:KECK, MELISSA ANN (AMFT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:KECK
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19833 AMERICAN AVE
Mailing Address - Street 2:
Mailing Address - City:HILMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95324-9328
Mailing Address - Country:US
Mailing Address - Phone:209-277-8429
Mailing Address - Fax:
Practice Address - Street 1:1351 GEER RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3269
Practice Address - Country:US
Practice Address - Phone:209-427-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT151783106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist