Healthcare Provider Details

I. General information

NPI: 1942842786
Provider Name (Legal Business Name): DENISE R MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W GABILAN ST
SALINAS CA
93901-2762
US

IV. Provider business mailing address

1375 NEW HAMPSHIRE CT
SALINAS CA
93905-4625
US

V. Phone/Fax

Practice location:
  • Phone: 831-758-0181
  • Fax:
Mailing address:
  • Phone: 831-214-6227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: