MEDICARE: MS. SANDRA ADRIANA LORENZO MENDOZA JR.

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	374J00000X	Doula

General Provider Information

NPI Number	:	1942176052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA ADRIANA LORENZO MENDOZA JR.

Provider Business Mailing Address
First Line	:	487 105TH AVE APT B
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94603-2943
Country	:	US
Telephone Number	:	510-689-4957
Fax Number	:

Provider Business Practice Location Address
First Line	:	487 105TH AVE APT B
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94603-2943
Country	:	US
Telephone Number	:	510-689-4957
Fax Number	:

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

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	10/15/2025

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