Provider Demographics
NPI:1306511795
Name:ARMADA, MELISSA MARIE JONSON
Entity type:Individual
Prefix:
First Name:MELISSA MARIE
Middle Name:JONSON
Last Name:ARMADA
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 1:1235 MCHENRY AVE STE A&B
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5370
Mailing Address - Country:US
Mailing Address - Phone:209-238-7875
Mailing Address - Fax:
Practice Address - Street 1:1235 MCHENRY AVE STE A&B
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5370
Practice Address - Country:US
Practice Address - Phone:209-238-7875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician