Healthcare Provider Details

I. General information

NPI: 1326506965
Provider Name (Legal Business Name): NATALIE RODRIGUEZ MEJIA AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2019
Last Update Date: 01/26/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 W SHAW AVE
FRESNO CA
93711-3242
US

IV. Provider business mailing address

3451 W SHAW AVE
FRESNO CA
93711-3242
US

V. Phone/Fax

Practice location:
  • Phone: 559-492-8327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF125890
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: