Healthcare Provider Details

I. General information

NPI: 1255204855
Provider Name (Legal Business Name): ANITHSIA MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 E HUNT HWY STE 102
SAN TAN VALLEY AZ
85143-5096
US

IV. Provider business mailing address

25640 N POSEIDON RD
FLORENCE AZ
85132-5531
US

V. Phone/Fax

Practice location:
  • Phone: 602-684-6622
  • Fax: 602-322-9818
Mailing address:
  • Phone: 602-684-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number050168
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: