Healthcare Provider Details

I. General information

NPI: 1336429760
Provider Name (Legal Business Name): ANA MEJIA-ALFRED CM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANA C MEJIA

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 MAVERICK CT
GRANBURY TX
76049-1381
US

IV. Provider business mailing address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

V. Phone/Fax

Practice location:
  • Phone: 188-873-1899
  • Fax: 833-775-1861
Mailing address:
  • Phone: 188-873-1899
  • Fax: 833-775-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11020156
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95022969
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP13324
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: