Provider Demographics
NPI:1578843843
Name:MELO, SEBASTIAN (ASW)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:MELO
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GOLDEN GATE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3706
Mailing Address - Country:US
Mailing Address - Phone:415-674-6389
Mailing Address - Fax:415-674-6378
Practice Address - Street 1:230 GOLDEN GATE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3706
Practice Address - Country:US
Practice Address - Phone:415-674-6389
Practice Address - Fax:415-674-6378
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health