Provider Demographics
NPI:1851949119
Name:MEREDITH E. MEBANE, LCSW
Entity Type:Organization
Organization Name:MEREDITH E. MEBANE, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MEBANE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:949-677-3689
Mailing Address - Street 1:42328 CORTE VILLOSA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42328 CORTE VILLOSA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3619
Practice Address - Country:US
Practice Address - Phone:949-677-3689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health