Provider Demographics
NPI:1790466209
Name:CHANG, MELINDA (MS, CGC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LA CASA VIA STE 140
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3005
Mailing Address - Country:US
Mailing Address - Phone:925-947-3378
Mailing Address - Fax:
Practice Address - Street 1:133 LA CASA VIA STE 140
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3005
Practice Address - Country:US
Practice Address - Phone:925-947-3378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPGC10024170300000X
CAGC001824170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS