Provider Demographics
NPI:1003836578
Name:MESKIN, LETTY N (MFT)
Entity type:Individual
Prefix:MRS
First Name:LETTY
Middle Name:N
Last Name:MESKIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 PACIFIC HWY
Mailing Address - Street 2:#1902
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3327
Mailing Address - Country:US
Mailing Address - Phone:760-940-0880
Mailing Address - Fax:760-930-9157
Practice Address - Street 1:2831 CAMINO DEL RIO S
Practice Address - Street 2:STE. 211
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3802
Practice Address - Country:US
Practice Address - Phone:760-940-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist