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NPI Code Detail

MEDICARE: DR. MARIBEL MEJIA PH.D.

MEDICARE: DR. MARIBEL MEJIA PH.D.
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
1103TC0700XClinical PsychologistPSY20953CA

General Provider Information

NPI Number : 1831229038
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIBEL MEJIA PH.D.
Provider Business Mailing Address
First Line : 1721 GRIFFIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3062
Country : US
Telephone Number : 213-221-4134
Fax Number : 323-221-3231
Provider Business Practice Location Address
First Line : 1721 GRIFFIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3062
Country : US
Telephone Number : 213-221-4134
Fax Number : 323-221-3231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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