Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 347568 | CA |
NPI | 1033234190 |
---|---|
Provider Name | Ms. Arlene Melville |
First Address | Pleasanton, CA 94588-5801 |
Second Address | Pleasanton, CA 94588-5801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
347568 | LICENSE (01) | CA |