Provider Demographics
NPI:1851771653
Name:MEJIA, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MEJIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 PRICE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063
Mailing Address - Country:US
Mailing Address - Phone:626-531-6999
Mailing Address - Fax:626-531-6998
Practice Address - Street 1:6746 VALJEAN AVE
Practice Address - Street 2:102
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-5848
Practice Address - Country:US
Practice Address - Phone:626-531-6999
Practice Address - Fax:626-531-6998
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health