Individual
MS. MELISSA ANNE JETHANANDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4441 E KINGS CANYON RD, FRESNO, CA 93702-3604
(559) 600-9180
Mailing address
245 11TH ST., SAN FRANCISCO, CA 94103
(415) 355-0311
(864) 512-1823
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95002315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0891
—
SC
Enumeration date
08/28/2006
Last updated
09/13/2021
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