Provider Demographics
NPI:1700082302
Name:MEEKS, LORITA FAYE (CADACII)
Entity Type:Individual
Prefix:MRS
First Name:LORITA
Middle Name:FAYE
Last Name:MEEKS
Suffix:
Gender:F
Credentials:CADACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S VICTORIA AVE RM 301
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93009-0001
Mailing Address - Country:US
Mailing Address - Phone:805-654-3758
Mailing Address - Fax:805-654-3732
Practice Address - Street 1:800 S VICTORIA AVE
Practice Address - Street 2:ROOM 301
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93009-0001
Practice Address - Country:US
Practice Address - Phone:805-654-3758
Practice Address - Fax:805-654-3732
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA3566289101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA3566289OtherCADCII