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General NPI Number Information
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NPI Number | 1699806901
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Entity Type | Individual
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Provider Name | JUDY ELLEN MEZA LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 6305 WOODMAN AVE
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City | VAN NUYS
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State | CA
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Zip | 91401-2346
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Country | US
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Telephone | 818-909-3382
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 221162
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City | NEWHALL
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State | CA
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Zip | 91322-1162
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Country | US
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Telephone | 661-253-1534
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT33294
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License Number State | CA
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