Healthcare Provider Details

I. General information

NPI: 1154241461
Provider Name (Legal Business Name): GEANNA MAGDALENA MENDEZ MPH, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4239 MAINE AVE
BALDWIN PARK CA
91706-3312
US

IV. Provider business mailing address

126 S CALIFORNIA ST APT E
SAN GABRIEL CA
91776-1541
US

V. Phone/Fax

Practice location:
  • Phone: 626-851-8191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: