Individual
MELISSA DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
4001 HIGHWAY 104, IONE, CA 95640
(805) 206-5510
Mailing address
4001 HIGHWAY 104, IONE, CA 95640
(805) 206-5510
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
23576
CA
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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