Melissa Licea

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

4524136 Issued in CA

Practice address

4382 Wright Brothers St
Jurupa Valley, CA 92509-7831

Phone

(951) 703-5355

NPI assigned

Jul 21, 2026

Last updated

Jul 21, 2026By 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

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

{
    "created_epoch": "1784592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1619897345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4382 WRIGHT BROTHERS ST",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925097831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4382 WRIGHT BROTHERS ST",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925097831",
            "telephone_number": "951-703-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICEA",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "4524136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Jurupa Valley, CA
• Providers in Jurupa Valley, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.