Individual
MELLISSA DERDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
592 RIO LINDO AVE, CHICO, CA 95926-1817
(530) 891-2999
Mailing address
457 SCARLET OAK DR, GRIDLEY, CA 95948-3221
(530) 846-4888
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT34371
CA
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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