Healthcare Provider Details

I. General information

NPI: 1851145122
Provider Name (Legal Business Name): DIANA MENDOZA MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10250 N 124TH ST
SCOTTSDALE AZ
85259-5201
US

IV. Provider business mailing address

10250 N 124TH ST
SCOTTSDALE AZ
85259-5201
US

V. Phone/Fax

Practice location:
  • Phone: 480-400-0850
  • Fax: 602-860-6050
Mailing address:
  • Phone: 480-400-0850
  • Fax: 602-860-6050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN226853
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP226853
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: