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General NPI Number Information
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NPI Number | 1396625380
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Entity Type | Individual
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Provider Name | JORGINA ANN MEZA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 17330 BEAR VALLEY RD # A106
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City | VICTORVILLE
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State | CA
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Zip | 92395-7741
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Country | US
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Telephone | 760-503-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 14020 IRIS CV
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City | VICTORVILLE
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State | CA
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Zip | 92392-5512
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Country | US
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Telephone | 323-401-5144
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | Y9007914
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License Number State | CA
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