Kifle Tsegaw Melisse, LPT

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

40207 Issued in CA

Practice address

1215 1St St
Gilroy, CA 95020-4733

Phone

(408) 852-2481

NPI assigned

Jul 28, 2023

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South County Behavioral Health

  • Psychiatric/Mental Health Registered Nurse
  • Gilroy, CA
  • NPI 1992484174
  NPD

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1215618525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 SEDONA WAY",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950209617",
            "telephone_number": "408-476-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 1ST ST",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950204733",
            "telephone_number": "408-852-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELISSE",
        "first_name": "KIFLE",
        "middle_name": "TSEGAW",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "40207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Mejorado
• Tenagnework Mekbeb, M.D.
• Mireya D Melchor
• Annabell Melgoza-Lopez
• Jasmin Melgoza-Lopez
• Louis Menacho
• Jocelyn Mendez Tabares
• Jenifer Oyuki Mendez-Villalobos I
• Joanna Leslie Mendez
• Marylou Mendez

• Licensed Psychiatric Technician in Gilroy, CA
• Providers in Gilroy, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.