Individual provider Active NPI

Melissa Anne Jethanandani, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1508974791
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95002315 Issued in CA
Practice address
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone
(559) 600-9180
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP713924 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95002315 CA Primary

Addresses

Primary practice location

4441 E Kings Canyon Rd
Fresno, CA 93702-3604

Mailing address

245 11TH St.
San Francisco, CA 94103
Phone (415) 355-0311

Other practice location 1

245 11th St
San Francisco, CA 94103
Phone (415) 355-0311

Other practice location 2

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

Other practice location 3

3133 E. Millbrook Ave.
Fresno, CA 93703
Phone (559) 600-9180

Other identifiers 1

IdentifierTypeStateIssuer
NP0891MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170405002232 CA Practitioner - Nurse Practitioner 0244271401 Reassigns benefits to 2 organizations
I20260616000969 GA Practitioner - Nurse Practitioner 0244271401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of FresnoGroup PAC ID 4981591690, 22 clinicians

Practice addresses (Care Compare)

4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 600-9193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1950SCMDRegistered Dietitian
APRN-NP713924GAMDPsychiatric/Mental Health Nurse Practitioner
95002315CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation CurrentSince Jul 12, 2022 Accepting new patients
County of Fresno CurrentSince Jul 18, 2022 Accepting new patients
County of Fresno CurrentSince Jul 18, 2022 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

Locations

4441 E Kings Canyon Rd
Fresno, CA 93702
Phone (559) 453-4099

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1508974791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 11TH ST.",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94103",
            "telephone_number": "415-355-0311",
            "fax_number": "864-512-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 11th St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94103",
            "country_code": "US",
            "telephone_number": "415-355-0311",
            "fax_number": "864-512-1823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 Redmond Cir NW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301651307",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3133 E. Millbrook Ave.",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93703",
            "country_code": "US",
            "telephone_number": "559-600-9180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JETHANANDANI",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP713924",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95002315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0891",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.