Healthcare Provider Details

I. General information

NPI: 1538724083
Provider Name (Legal Business Name): VERONICA L MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

IV. Provider business mailing address

1801 HUNTINGTON DR
DUARTE CA
91010-2686
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-6800
  • Fax:
Mailing address:
  • Phone: 626-993-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT124555
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: