Healthcare Provider Details

I. General information

NPI: 1508729252
Provider Name (Legal Business Name): JENNIFER OLGUIN-MENDOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MOONEY BLVD
VISALIA CA
93277-4403
US

IV. Provider business mailing address

844 W KIMBALL AVE
VISALIA CA
93277-6571
US

V. Phone/Fax

Practice location:
  • Phone: 800-207-0272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: