Healthcare Provider Details

I. General information

NPI: 1508983016
Provider Name (Legal Business Name): REBECA MEZA MEJIA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E WILLOW ST
SIGNAL HILL CA
90755-2736
US

IV. Provider business mailing address

845 E WILLOW ST
SIGNAL HILL CA
90755-2736
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-6542
  • Fax:
Mailing address:
  • Phone: 310-325-6542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT107007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: