MEDICARE: MS. MECAH BLANCHE PARIS LCSW

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	1041C0700X	Clinical Social Worker	117969	CA

General Provider Information

NPI Number	:	1811775638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MECAH BLANCHE PARIS LCSW

Provider Business Mailing Address
First Line	:	6747 WINDING CREEK DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1145
Country	:	US
Telephone Number	:	619-201-7580
Fax Number	:

Provider Business Practice Location Address
First Line	:	6747 WINDING CREEK DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1145
Country	:	US
Telephone Number	:	619-201-7580
Fax Number	:

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

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	09/21/2023

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