Healthcare Provider Details

I. General information

NPI: 1447093083
Provider Name (Legal Business Name): BEATRIZ ADEMAR MEZA PAYAN ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18302 IRVINE BLVD # 375
TUSTIN CA
92780-3435
US

IV. Provider business mailing address

18302 IRVINE BLVD # 375
TUSTIN CA
92780-3435
US

V. Phone/Fax

Practice location:
  • Phone: 714-393-9969
  • Fax:
Mailing address:
  • Phone: 714-661-5390
  • Fax: 714-661-5449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1339937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: