MELISSA LEE VAN WAGENEN (NPI# 1902326507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902326507 |
| Entity Type | Individual |
| Full Name | MELISSA LEE VAN WAGENEN |
| Credential | LMFTI |
| Practice Address |
643 Bair Island Rd # 301 Redwood City CA 94063-2754 |
| Mailing Address |
Po Box 92152 Pasadena CA 91109-2152 |
| Practice Telephone | 6504240852 |
| Mailing Telephone | 8187209152 |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2017-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | IMF96544 | CA | Behavioral Health & Social Service Providers |
| Street Address |
643 BAIR ISLAND RD # 301 |
| City | REDWOOD CITY |
| State | CA |
| Zip Code | 94063-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578104378 | Jade Francetich | Psychologist | 450 Broadway St., Pavilion B 2nd Floor, Redwood City, CA 94063 | 2019-10-02 |
| 1861052060 | County of San Mateo | Clinic/Center | 1300 Maple St., Redwood City, CA 94063 | 2019-06-19 |
| 1750941977 | County of San Mateo | Clinic/Center | 300 Bradford St., Redwood City, CA 94063 | 2019-06-19 |
| 1023678661 | Linda K Watanabe | Preventive Medicine | 700 Bay Rd. #2803, Redwood City, CA 94063 | 2019-06-17 |
| 1235630369 | Waverly Place Apartments, Lp | Case Management | 105 Waverly Place, Redwood City, CA 94063 | 2018-02-23 |
| 1306371679 | Caely Alise Hambro | Student in an Organized Health Care Education/Training Program | Stanford Dermatology, 430 Broadway, Redwood City, CA 94063 | 2017-04-25 |
| 1609316736 | Justine Nicole Dela Cruz | Nurse Practitioner | 420 Broadway St # D, Redwood City, CA 94063 | 2017-03-08 |
| 1336683234 | Babita Chopra | Pharmacist | 2300 Middlefield Road, Redwood City, CA 94063 | 2016-12-12 |
| 1073065595 | Diana Genoveva Posner I | Counselor | 604 Prince Ave. Ste A, Redwood City, CA 94063 | 2016-11-01 |
| 1295288264 | Benjamin Dickter | Student in an Organized Health Care Education/Training Program | 1107 2nd Ave, Apt 103, Redwood City, CA 94063 | 2016-07-26 |
| Find all providers in zip 94063 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412109 | Ashlie Schoenhardt Duplichen | Marriage & Family Therapist | 333 Main St Apt 325, Redwood City, CA 94063-1773 | 2020-09-22 |
| 1891320586 | Gina Garcia | Marriage & Family Therapist | 626 Jefferson Ave Ste 4, Redwood City, CA 94063-1726 | 2020-03-03 |
| 1588126064 | Anne Caulley | Marriage & Family Therapist | 155 Birch St Ste 2, Redwood City, CA 94062-1340 | 2019-04-03 |
| 1073020004 | Susana Navarro Ramos | Marriage & Family Therapist | 2580 El Camino Real, Redwood City, CA 94061-3899 | 2017-12-28 |
| 1255869475 | Herberth S Rivera | Marriage & Family Therapist | 2000 Broadway St Ste 272, Redwood City, CA 94063-1843 | 2017-06-01 |
| 1326581455 | Monica Lynn Ippolito | Marriage & Family Therapist | 643 Bair Island Rd Ste 301, Redwood City, CA 94063-2757 | 2016-11-21 |
| 1255799888 | Theresa Raymer | Marriage & Family Therapist | 499 Seaport Ct Ste 201, Redwood City, CA 94063-2762 | 2016-02-10 |
| 1205211539 | Stephanie Balistreri | Marriage & Family Therapist | 1900 Poplar Ave, Redwood City, CA 94061-2104 | 2015-07-28 |
| 1174904031 | Stephanie Olano | Marriage & Family Therapist | 394 Sequoia Ave, Redwood City, CA 94061-3444 | 2015-06-16 |
| 1184004210 | Luis Enique Suarez | Marriage & Family Therapist | 611 Veterans Blvd Ste 102, Redwood City, CA 94063-1462 | 2015-06-03 |
| Find all providers in REDWOOD CITY | ||||
| City | REDWOOD CITY |
| Zip Code | 94063 |
Please comment or provide details below to improve the information on MELISSA LEE VAN WAGENEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.