Provider Demographics
NPI:1619205911
Name:MEJIAS, NIRA O (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NIRA
Middle Name:O
Last Name:MEJIAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7365 CARNELIAN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1157
Mailing Address - Country:US
Mailing Address - Phone:951-218-0951
Mailing Address - Fax:877-850-5695
Practice Address - Street 1:7365 CARNELIAN ST STE 202
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1157
Practice Address - Country:US
Practice Address - Phone:951-218-0951
Practice Address - Fax:877-850-5695
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 25313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCSW69746OtherBBS