Melissa Stallard, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY33306 Issued in CA

Practice address

9479 Haven Ave
Rancho Cucamonga, CA 91730-5844

Phone

(909) 908-6285

NPI assigned

Jul 5, 2022

Last updated

Jul 5, 2022By 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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melissa.stallard.1@28621.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Behavioral Care of California, P.C.

  • Clinical Psychologist
  • Rancho Cucamonga, CA
  • NPI 1417718297
  NPD
• Optum Behavioral Care of California, P.C.

  • Clinical Social Worker
  • Costa Mesa, CA
  • NPI 1447137740
  NPD

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1952034290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 SEMINOLE WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9479 HAVEN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305844",
            "telephone_number": "909-908-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLARD",
        "first_name": "MELISSA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Joseph Health System Home Care Services LLC (Providence Hospice Inland Empire)
• Stacey Ann Tobie a Professional Psychology Corporation
• Stacie Fanelli, Licensed Clinical Social Worker, Professional Corporation (Autonomous Minds Therapy)
• Genesis Audrey Staff
• Charlotte T Stahl
• Carmen N Stamey
• Jaylyn A Stample, RBT
• Joanne Stanart
• Danielle Kathleen Stancikas, LMFT, APCC
• Cathryn Stanskas

• Clinical Psychologist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.