Active NPI
Jeanne Lynn Melvin, MS
- Speech/Language/Hearing Specialist/Technologist
- Venice, CA
National Provider Identifier
1710003900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech/Language/Hearing Specialist/Technologist
- License
- OT3809
- Practice address
- 2458 Walnut Ave
Venice, CA 90291-5019 - Phone
- (310) 306-4247
- Fax
- (310) 306-3903
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech/Language/Hearing Specialist/Technologist | 235500000X | OT3809 | CA | Primary |
Addresses
Primary practice location
2458 Walnut Ave
Venice, CA 90291-5019
Mailing address
2458 Walnut Ave
Venice, CA 90291-5019
Phone (310) 306-4247
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3809 | CA | MD | Occupational Therapy Assistant |
| OT3809 | CA | MD | Speech/Language/Hearing Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590019200000",
"number": "1710003900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2458 WALNUT AVE",
"city": "VENICE",
"state": "CA",
"postal_code": "902915019",
"telephone_number": "310-306-4247",
"fax_number": "310-306-3903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2458 WALNUT AVE",
"city": "VENICE",
"state": "CA",
"postal_code": "902915019",
"telephone_number": "310-306-4247",
"fax_number": "310-306-3903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELVIN",
"first_name": "JEANNE",
"middle_name": "LYNN",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2020-05-21",
"certification_date": "2020-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "235500000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist",
"state": "CA",
"license": "OT3809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.