Phyllis Melvin, R.N.,N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

171502 Issued in CA

Practice address

1520 Madeira Dr
Pacifica, CA 94044-4333

Phone

(650) 359-8745

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053520692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 MADEIRA DR",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940444333",
            "telephone_number": "650-359-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 MADEIRA DR",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940444333",
            "telephone_number": "650-359-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "PHYLLIS",
        "credential": "R.N.,N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "171502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayhem Unity Limited Liabilty Company
• Charlotte McCall, LCSW
• Bryan P McDade
• Sandra Jean McDade, PT MPA
• Marvin George McLarty III, REG. RECOVERY WORKER
• Eric Metzgar, AMFT
• Robin Middough, MS, LMFT
• Batya Miller, MSW
• Ronald Duane Mitchell, D.C.
• Phyllis Andrea Monah Nunez

• Nurse Practitioner in Pacifica, CA
• Providers in Pacifica, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.