| Doctor Name: | MR. FRANK RAY MESA |
| NPI Number: | 1225202054 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | A010860315 |
| Business Practice Address: | 1021 4th Street Ste B Taft, CA - 93268 |
| Business Phone Number: | 6617657025 |
| Business Fax Number: | 6617580891 |
| Mailing Address: | 29325 Kimberlina Rd., WASCO |
| State: | CA |
| Postal Code: | 932801000 |
| Phone Number: | 6617584029 |
| Fax Number: | 6617580891 |
| NPI Enumeration Date: | 04/14/2008 |
| NPI Last Update Date: | 11/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | A010860315 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |