Healthcare Provider Details

I. General information

NPI: 1316293327
Provider Name (Legal Business Name): MARIA ALEJANDRA MEJIA RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2890 PIO PICO DR STE 200A
CARLSBAD CA
92008-1558
US

IV. Provider business mailing address

PO BOX 514
CARLSBAD CA
92018-0514
US

V. Phone/Fax

Practice location:
  • Phone: 760-683-9407
  • Fax: 760-452-4078
Mailing address:
  • Phone: 760-683-9407
  • Fax: 760-452-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number79743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: