NPI Code Details Logo

NPI 1396533527

NPI 1396533527 : SALECIA FAYE MEKANISI M.ED. , PPS, NCSP : ANTIOCH, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1396533527
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SALECIA FAYE MEKANISI M.ED. , PPS, NCSP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/28/2025
-----------------------------------------------------
    Last Update Date     |    04/28/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1500 D ST 
-----------------------------------------------------
    City                 |    ANTIOCH
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94509-2346
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    925-779-7400
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3350 E 7TH ST # 246 
-----------------------------------------------------
    City                 |    LONG BEACH
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    90804-5003
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    714-616-2532
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103TS0200X
-----------------------------------------------------
    Taxonomy Name        |    School Psychologist
-----------------------------------------------------
    License Number       |    230009351
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.