Basic Information
| Provider Information | |||||||||
| NPI: | 1043951460 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINNEGAN | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | LEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4281 KATELLA AVE STE 117 | ||||||||
| Address2: | |||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907203590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625960050 | ||||||||
| FaxNumber: | 5625960058 | ||||||||
| Practice Location | |||||||||
| Address1: | 4281 KATELLA AVE STE 117 | ||||||||
| Address2: | |||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907203590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625960050 | ||||||||
| FaxNumber: | 5625960058 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2022 | ||||||||
| LastUpdateDate: | 07/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.