Healthcare Provider Details

I. General information

NPI: 1700731080
Provider Name (Legal Business Name): JESSICA VERONICA GONZALEZ MENDOZA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 N BELLFLOWER BLVD STE 102
LONG BEACH CA
90815-4019
US

IV. Provider business mailing address

6802 LEMON AVE
LONG BEACH CA
90805-1530
US

V. Phone/Fax

Practice location:
  • Phone: 949-805-2100
  • Fax:
Mailing address:
  • Phone: 562-387-4106
  • Fax: 562-387-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNPF95038441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: