STACI MELISSA MINTZ
NPI 1881113835
Psychologist in Reseda, CA

Active since September 11, 2017
19013 VANOWEN ST, RESEDA, CA 91335(818) 968-1215 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 26, 2026, Jul 28, 2022, Sep 11, 2017 (3 updates tracked since 2017).

About Staci Melissa Mintz NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACI MELISSA MINTZ (NPI 1881113835) is an individual psychologist in Reseda, California and active in the NPI registry since September 2017. She is a graduate of Other (2020).

NPPES Registry Identity

NPI1881113835
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameSTACI MELISSA MINTZ
Location Address19013 VANOWEN STReseda, CA 91335-5115
Mailing Address6345 Balboa Blvd Ste 212Encino, CA 91316-1517 · (818) 968-1215
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 11, 2017
Last NPPES UpdateMay 26, 20263 updates tracked since enumeration
NPPES CertifiedMay 26, 2026
NPI 1881113835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
19013 VANOWEN ST, Reseda, CA 91335

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Staci Melissa Mintz is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547656431
PECOS Enrollment IDI20220331002756

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Staci Mintz's NPI number?

The NPI number for Staci Mintz is 1881113835. It was assigned to this individual provider in the NPPES registry on September 11, 2017.

Where is Staci Mintz located?

Staci Mintz practices at 19013 Vanowen St, Reseda, CA 91335. The listed phone number is (818) 968-1215.

What is Staci Mintz's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Staci Mintz enrolled in Medicare?

Yes. Staci Mintz is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Staci Mintz was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.