Healthcare Provider Details

I. General information

NPI: 1548146731
Provider Name (Legal Business Name): MIRNA ABRIL MEJIA MUNGUIA BA, BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 HOSPITAL DR
SACRAMENTO CA
95823-5405
US

IV. Provider business mailing address

2920 RAMONA AVE APT 3213B
SACRAMENTO CA
95826-3858
US

V. Phone/Fax

Practice location:
  • Phone: 866-227-1211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-322570
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: