Provider Demographics
NPI:1871722199
Name:PIERCE, MELISSA S (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:S
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 HARDING ST STE 109
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1818
Mailing Address - Country:US
Mailing Address - Phone:760-814-1321
Mailing Address - Fax:855-955-1321
Practice Address - Street 1:2945 HARDING ST STE 109
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1818
Practice Address - Country:US
Practice Address - Phone:760-814-1321
Practice Address - Fax:855-955-1321
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26118103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416OtherPCSD MEDICARE #