Basic Information
Provider Information
NPI: 1104448240
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARKLEY
FirstName: MELIA
MiddleName: SHEH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8140 SUNLAND BLVD
Address2:  
City: SUN VALLEY
State: CA
PostalCode: 913523948
CountryCode: US
TelephoneNumber: 8185828832
FaxNumber: 8185828836
Practice Location
Address1: 8140 SUNLAND BLVD
Address2:  
City: SUN VALLEY
State: CA
PostalCode: 913523948
CountryCode: US
TelephoneNumber: 8185828832
FaxNumber: 8185828836
Other Information
ProviderEnumerationDate: 05/12/2020
LastUpdateDate: 05/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
374700000XR1386100420CAY Nursing Service Related ProvidersTechnician 

No ID Information.


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