Individual
ALISA RENAE MELOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDRC
Contact information
Practice address
1111 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 451-5272
(209) 938-0281
Mailing address
4205 ROSE PARADE, MODESTO, CA 95357-0842
(408) 590-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21438
CA
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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