Healthcare Provider Details

I. General information

NPI: 1861024465
Provider Name (Legal Business Name): MS. DANIELA MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 S MAIN ST
SALINAS CA
93901-2323
US

IV. Provider business mailing address

2560 GARDEN RD
MONTEREY CA
93940-5338
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-4828
  • Fax: 831-424-5838
Mailing address:
  • Phone: 831-658-3811
  • Fax: 831-658-3815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number10303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: