| Doctor Name: | DR. MELISSA DIANE CERVANTES |
| NPI Number: | 1053752634 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PSY26430 |
| Business Practice Address: | 12450 Van Nuys Blvd Suite 200 Pacoima, CA - 913311391 |
| Business Phone Number: | 8188961161 |
| Business Fax Number: | 8188965069 |
| Mailing Address: | 12450 Van Nuys Blvd, Suite 200 PACOIMA |
| State: | CA |
| Postal Code: | 913311391 |
| Phone Number: | 8188961161 |
| Fax Number: | 8188965069 |
| NPI Enumeration Date: | 07/11/2013 |
| NPI Last Update Date: | 05/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY26430 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |