MEDICARE: RACHEL MENDOZA LASTIMOSA AMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	158167	CA

General Provider Information

NPI Number	:	1083571293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MENDOZA LASTIMOSA AMFT

Provider Business Mailing Address
First Line	:	PO BOX 24012
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94124-0012
Country	:	US
Telephone Number	:	415-570-7433
Fax Number	:

Provider Business Practice Location Address
First Line	:	3316 LAGUNA WAY STE B
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-2818
Country	:	US
Telephone Number	:	415-570-7433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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