Healthcare Provider Details

I. General information

NPI: 1770016255
Provider Name (Legal Business Name): MELISSA MEJIA M.S.,BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4688 ONTARIO MILLS PKWY
ONTARIO CA
91764-5104
US

IV. Provider business mailing address

4688 ONTARIO MILLS PKWY
ONTARIO CA
91764-5104
US

V. Phone/Fax

Practice location:
  • Phone: 949-685-4322
  • Fax:
Mailing address:
  • Phone: 949-685-4322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-24984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: