Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | PSY23411 | CA |
N | 103T00000X | Psychologist | PSY23411 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1578757621 |
---|---|
Provider Name | Melanie J Cain |
First Address | Cerritos, CA 90703-2640 |
Second Address | Cerritos, CA 90703-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 10/02/2021 |