Active NPI
Roger Jackson Melton, LMFT
- Marriage & Family Therapist
- Moreno Valley, CA
National Provider Identifier
1447459714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC17474
- Practice address
- 12815 Heacock St.
CDRP/Pain Management
Moreno Valley, CA 92553 - Phone
- (951) 601-6174
- NPI assigned
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | MFC17474 | CA | Primary |
Addresses
Primary practice location
12815 Heacock St.
CDRP/Pain Management
Moreno Valley, CA 92553
Mailing address
12815 Heacock St.
CDRP/Pain Management
Moreno Valley, CA 92553
Phone (951) 601-6174
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC17474 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1447459714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12815 HEACOCK ST.",
"address_2": "CDRP/PAIN MANAGEMENT",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "92553",
"telephone_number": "951-601-6174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12815 HEACOCK ST.",
"address_2": "CDRP/PAIN MANAGEMENT",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "92553",
"telephone_number": "951-601-6174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELTON",
"first_name": "ROGER",
"middle_name": "JACKSON",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-16",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC17474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.