MEDICARE: GUADALUPE MENCHACA

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1427465566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUADALUPE MENCHACA

Provider Business Mailing Address
First Line	:	149 3RD ST
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-1840
Country	:	US
Telephone Number	:	805-990-6519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 CAMINO DEL SOL STE 1
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-3725
Country	:	US
Telephone Number	:	805-604-5437
Fax Number	:

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

Provider Enumeration Date	:	07/21/2014
Last Update Date	:	02/09/2026

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Directions to “ GUADALUPE MENCHACA ” Practice Location

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