Healthcare Provider Details

I. General information

NPI: 1922017698
Provider Name (Legal Business Name): ANA E MENDOZA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANA E MENDOZA M.D

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5588 N PALM AVE
FRESNO CA
93704-1913
US

IV. Provider business mailing address

9162 N WOODLAWN DR
FRESNO CA
93720-1290
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-4548
  • Fax:
Mailing address:
  • Phone: 559-433-4686
  • Fax: 559-433-4686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA85866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: