MEDICARE: MISTY ANNE MEJIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	82181	CA
2	106H00000X	Marriage & Family Therapist	109583	CA

General Provider Information

NPI Number	:	1285074195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISTY ANNE MEJIA

Provider Business Mailing Address
First Line	:	44550 VILLAGE CT STE 103
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3817
Country	:	US
Telephone Number	:	951-396-1395
Fax Number	:

Provider Business Practice Location Address
First Line	:	44550 VILLAGE CT STE 103
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3817
Country	:	US
Telephone Number	:	951-396-1395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2013
Last Update Date	:	12/04/2024

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Directions to “ MISTY ANNE MEJIA ” Practice Location

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