Healthcare Provider Details

I. General information

NPI: 1679294730
Provider Name (Legal Business Name): ERIKA MEJIA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 OLD TUSTIN AVE
SANTA ANA CA
92705-7811
US

IV. Provider business mailing address

5360 SILVER CANYON RD UNIT C
YORBA LINDA CA
92887-3940
US

V. Phone/Fax

Practice location:
  • Phone: 171-483-5663
  • Fax:
Mailing address:
  • Phone: 562-631-6447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: