Basic Information
Provider Information
NPI: 1821282641
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARLAND
FirstName: MELBA
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1563 MISSION ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941032543
CountryCode: US
TelephoneNumber: 4157623700
FaxNumber: 4158650119
Practice Location
Address1: 1601 DONNER AVE STE 3
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941243277
CountryCode: US
TelephoneNumber: 4157623700
FaxNumber: 4158650119
Other Information
ProviderEnumerationDate: 09/05/2007
LastUpdateDate: 08/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
103T00000X  N Behavioral Health & Social Service ProvidersPsychologist 
106H00000X  Y Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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