Individual
MELLODIE BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5980 STONERIDGE DR STE 100, PLEASANTON, CA 94588-2723
(925) 847-8833
Mailing address
24091 MADEIROS AVE, HAYWARD, CA 94541-4462
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT8270
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT8270
PTA LICENSE
CA
Enumeration date
06/15/2007
Last updated
07/08/2007
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