Provider Demographics
NPI:1245480250
Name:GROSFOGUEL-MEJIA, NADIA
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:GROSFOGUEL-MEJIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2712 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2712 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3104
Practice Address - Country:US
Practice Address - Phone:415-401-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker