Healthcare Provider Details

I. General information

NPI: 1750806329
Provider Name (Legal Business Name): VANESSA ESCALANTE MEJIA MSW, ACSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S TURNER AVE
WEST COVINA CA
91791-1844
US

IV. Provider business mailing address

209 S TURNER AVE
WEST COVINA CA
91791-1844
US

V. Phone/Fax

Practice location:
  • Phone: 626-806-7281
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: