Basic Information
| Provider Information | |||||||||
| NPI: | 1821277278 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEJIA | ||||||||
| FirstName: | DOLORES | ||||||||
| MiddleName: | SALINAS | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | MHW II | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 E 13TH ST STE A | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953416211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093816800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 83 E SHAW AVE | ||||||||
| Address2: | SUITE # 102 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592260167 | ||||||||
| FaxNumber: | 5592261559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2007 | ||||||||
| LastUpdateDate: | 05/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 061264 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YA0400X | 061254 | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.