Basic Information
Provider Information
NPI: 1518177617
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEMPEL
FirstName: MELISSA
MiddleName: JAYNE
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 HERMAN CIR
Address2:  
City: AUBURN
State: CA
PostalCode: 956034159
CountryCode: US
TelephoneNumber: 5308232131
FaxNumber:  
Practice Location
Address1: 4240 ROCKLIN RD
Address2: SUITE 5
City: ROCKLIN
State: CA
PostalCode: 956772862
CountryCode: US
TelephoneNumber: 9163150468
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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