Provider Demographics
NPI:1336429760
Name:MEJIA-ALFRED, ANA (CM)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:MEJIA-ALFRED
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:C
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:195 PAGE MILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-2073
Mailing Address - Country:US
Mailing Address - Phone:188-873-1899
Mailing Address - Fax:833-775-1861
Practice Address - Street 1:112 MAVERICK CT
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-1381
Practice Address - Country:US
Practice Address - Phone:188-873-1899
Practice Address - Fax:833-775-1861
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ7539036367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife