Montana Kaye Mellott, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

95223517 Issued in CA

Practice address

27930 Cabot Rd Unit 306
Laguna Niguel, CA 92677-1223

Phone

(480) 622-3372

NPI assigned

Nov 17, 2021

Last updated

Nov 17, 2021By the provider in NPPES

Sex

Female

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)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1700543485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27930 CABOT RD UNIT 306",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926771223",
            "telephone_number": "480-622-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27930 CABOT RD UNIT 306",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926771223",
            "telephone_number": "480-622-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "MONTANA",
        "middle_name": "KAYE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "95223517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Randell Wayne Mello, RPH
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• Mesisca Physical Therapy Inc
• Dennis John Mesisca, PHYSICAL THERAPIST
• Michelle C Mezin
• Michael D Moran, M.D., Inc.

• Addiction (Substance Use Disorder) Registered Nurse in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Addiction (Substance Use Disorder) Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.