Melissa Tacy Illario
Social Worker, Clinical in Anaheim, CA. Individual provider (NPI-1).
NPI number1629632575
StatusActive
Last updated in NPPESApr 15, 2026
Details
- NPI
- 1629632575
- Entity type
- Individual (NPI-1)
- Name
- Melissa Tacy Illario
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 25, 2019
- Certification date
- Apr 15, 2026
- Last updated
- Apr 15, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 121960 | CA | Yes |
| 1041C0700X | Social Worker, Clinical | 12877651-3501 | UT |
Practice location
1044 N Anaheim Blvd Unit 2Anaheim, CA 92801-7567
Phone 801-615-3160 · Fax 949-502-2802
Mailing address
1044 N Anaheim Blvd Unit 2Anaheim, CA 92801-7567
Phone 801-615-3160 · Fax 949-502-2802
Other practice locations
1437 E 920 N
Orem, UT 84097-4328
Orem, UT 84097-4328
Phone 801-899-9375
10362 S Ashley Meadows Cir
Sandy, UT 84092-7200
Sandy, UT 84092-7200
Phone 801-615-3160
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