| Doctor Name: | DR. MELISSA FREDETTE |
| NPI Number: | 1124323118 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 2156 |
| Business Practice Address: | 101 Bodin Cir 60 Mdg/sgop Travis Afb, CA - 945351809 |
| Business Phone Number: | 8473023537 |
| Business Fax Number: | |
| Mailing Address: | 101 Bodin Cir, 60 Mdg/sgop TRAVIS AFB |
| State: | CA |
| Postal Code: | 945351809 |
| Phone Number: | 8473023537 |
| Fax Number: | |
| NPI Enumeration Date: | 01/21/2011 |
| NPI Last Update Date: | 07/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2156 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |