Healthcare Provider Details

I. General information

NPI: 1265099501
Provider Name (Legal Business Name): MENDY MEJIA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7252 ARCHIBALD AVE
RANCHO CUCAMONGA CA
91701-5017
US

IV. Provider business mailing address

12065 MORRISON ST
MORENO VALLEY CA
92555-1802
US

V. Phone/Fax

Practice location:
  • Phone: 909-414-1346
  • Fax:
Mailing address:
  • Phone: 909-549-0799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: