Healthcare Provider Details

I. General information

NPI: 1689702813
Provider Name (Legal Business Name): ALEJANDRA MEZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11731 E. TELEGRAPH RD. BLDG G
SANTA FE SPRINGS CA
90670
US

IV. Provider business mailing address

561 CYPRESS AVE
PASADENA CA
91103-3313
US

V. Phone/Fax

Practice location:
  • Phone: 562-942-8256
  • Fax: 562-942-9789
Mailing address:
  • Phone: 626-744-9492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: