Healthcare Provider Details

I. General information

NPI: 1477337889
Provider Name (Legal Business Name): HELEN C MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15339 SATICOY ST
VAN NUYS CA
91406-3345
US

IV. Provider business mailing address

15339 SATICOY ST
VAN NUYS CA
91406-3345
US

V. Phone/Fax

Practice location:
  • Phone: 818-267-2760
  • Fax:
Mailing address:
  • Phone: 818-267-2760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number125492
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW125492
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: