Healthcare Provider Details

I. General information

NPI: 1326632670
Provider Name (Legal Business Name): IRIS LILIA MEZA CONTRERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 FAIRVIEW RD
BAKERSFIELD CA
93307-5512
US

IV. Provider business mailing address

10417 MAIN ST
LAMONT CA
93241-1726
US

V. Phone/Fax

Practice location:
  • Phone: 661-837-6000
  • Fax:
Mailing address:
  • Phone: 661-845-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number110184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: