Healthcare Provider Details

I. General information

NPI: 1437532371
Provider Name (Legal Business Name): DULCE MEJIA LCSW, PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3806 JEWETT AVENUE
BAKERSFIELD CA
93301
US

IV. Provider business mailing address

1300 BAKER ST
BAKERSFIELD CA
93305-4326
US

V. Phone/Fax

Practice location:
  • Phone: 661-631-3234
  • Fax: 661-863-0115
Mailing address:
  • Phone: 661-631-5895
  • Fax: 661-631-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberPPSC180014545
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW92782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: