Provider Demographics
NPI:1689711129
Name:DE SANCHEZ-DAVIS, MEKKIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEKKIA
Middle Name:
Last Name:DE SANCHEZ-DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 UNIVERSITY AVE 4TH FLOOR
Mailing Address - Street 2:M.H. WET
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501
Mailing Address - Country:US
Mailing Address - Phone:951-358-4255
Mailing Address - Fax:951-955-7207
Practice Address - Street 1:3801 UNIVERSITY AVE 4TH FLOOR
Practice Address - Street 2:M.H. WET
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501
Practice Address - Country:US
Practice Address - Phone:951-358-4255
Practice Address - Fax:951-955-7207
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS118751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical