Individual
MELISSA KATHLEEN CANCIO MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2449 PACHECO ST, CONCORD, CA 94520-2019
(916) 907-2261
Mailing address
5288 COLLECT LN, FAIRFIELD, CA 94534-4273
(707) 803-2930
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95118610
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1861738023
CA
Other
Enumeration date
12/17/2012
Last updated
06/11/2024
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