Healthcare Provider Details

I. General information

NPI: 1104756196
Provider Name (Legal Business Name): ELIZABETH MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 UNIVERSE CIR
OXNARD CA
93033-2441
US

IV. Provider business mailing address

1935 N H ST APT 79
OXNARD CA
93036-9085
US

V. Phone/Fax

Practice location:
  • Phone: 805-725-0640
  • Fax:
Mailing address:
  • Phone: 805-253-8404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: