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NPI Code Detail

MEDICARE: NELY E MEZA

MEDICARE:   NELY E MEZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLMFT 50232CA

General Provider Information

NPI Number : 1275612186
Entity Type Code : Individual
Provider Name (Legal Business Name) : NELY E MEZA
Provider Business Mailing Address
First Line : PO BOX 774
Second Line :
City : MONTROSE
State : CA
Zip : 91020-1801
Country : US
Telephone Number : 323-854-2160
Fax Number :
Provider Business Practice Location Address
First Line : 3171 LOS ANGELES BLVD SUITE 218
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-1527
Country : US
Telephone Number : 323-854-2160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 01/09/2017

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Directions to “ NELY E MEZA ” Practice Location

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