Provider Demographics
NPI:1346528452
Name:DUDIK, MELANIE A (OT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:DUDIK
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:ANGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1041 AUGUSTA CIR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-2734
Mailing Address - Country:US
Mailing Address - Phone:336-462-7613
Mailing Address - Fax:
Practice Address - Street 1:200 MERCY CIRCLE
Practice Address - Street 2:
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-719-3288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20318225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist