Healthcare Provider Details

I. General information

NPI: 1154275584
Provider Name (Legal Business Name): ANGELICA MENDEZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10611 E GREYS CREEK CT
CLOVIS CA
93619-4619
US

IV. Provider business mailing address

10611 E GREYS CREEK CT
CLOVIS CA
93619-4619
US

V. Phone/Fax

Practice location:
  • Phone: 661-992-4785
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: