Provider Demographics
NPI:1285719229
Name:TRONCIN-D'AMORE, MELISSA JACQUELINE
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JACQUELINE
Last Name:TRONCIN-D'AMORE
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 1:305 N FERNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3421
Mailing Address - Country:US
Mailing Address - Phone:415-381-2889
Mailing Address - Fax:
Practice Address - Street 1:555 NORTHGATE DR
Practice Address - Street 2:FAMILY SERVICE AGENCY
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3680
Practice Address - Country:US
Practice Address - Phone:415-491-5700
Practice Address - Fax:415-491-5750
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health