Individual provider Active NPI

Melissa Ann Sidnam, M.A.

  • Addiction (Substance Use Disorder) Counselor
  • Clayton, CA
National Provider Identifier
1306217898
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RADT-I122145 Issued in CA
Practice address
11540 Marsh Creek Rd
Clayton, CA 94517-9759
Phone
(925) 672-5700
NPI assigned
Oct 9, 2015
Last updated
Oct 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RADT-I122145 CA Primary

Addresses

Primary practice location

11540 Marsh Creek Rd
Clayton, CA 94517-9759

Mailing address

11540 Marsh Creek Rd
Clayton, CA 94517-9759
Phone (925) 672-5700

Other names 1

  • Melissa Ann Herman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
RADT-I122145CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bi-Bett PastSince Jun 21, 2020 Accepting new patients
Bi Bett Corporation Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1306217898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11540 MARSH CREEK RD",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945179759",
            "telephone_number": "925-672-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11540 MARSH CREEK RD",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945179759",
            "telephone_number": "925-672-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDNAM",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RADT-I122145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HERMAN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clayton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.