Healthcare Provider Details

I. General information

NPI: 1790435469
Provider Name (Legal Business Name): VALERIE NICHOLE MENDEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 E MAIN ST STE 210
SANTA MARIA CA
93454-4836
US

IV. Provider business mailing address

2050 S BLOSSER RD
SANTA MARIA CA
93458-7310
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-3678
  • Fax: 805-928-6408
Mailing address:
  • Phone: 805-361-8030
  • Fax: 805-361-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A25327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: