Healthcare Provider Details

I. General information

NPI: 1982951257
Provider Name (Legal Business Name): LAURA MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

IV. Provider business mailing address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

V. Phone/Fax

Practice location:
  • Phone: 213-699-7411
  • Fax:
Mailing address:
  • Phone: 213-699-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number71401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: