Provider Demographics
NPI:1306584271
Name:MEJIA, DEYSI ROSIBEL
Entity type:Individual
Prefix:
First Name:DEYSI
Middle Name:ROSIBEL
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 1:1180 HOWARD ST APT 208
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-6017
Mailing Address - Country:US
Mailing Address - Phone:415-864-0554
Mailing Address - Fax:415-826-6774
Practice Address - Street 1:1180 HOWARD ST APT 208
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-6017
Practice Address - Country:US
Practice Address - Phone:415-864-0554
Practice Address - Fax:415-826-6774
Is Sole Proprietor?:No
Enumeration Date:2022-05-21
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)