Healthcare Provider Details

I. General information

NPI: 1760348262
Provider Name (Legal Business Name): ISABELA MENDOZA- GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 READ ST LOT 64
OMAHA NE
68112-3482
US

IV. Provider business mailing address

1909 READ ST LOT 64
OMAHA NE
68112-3482
US

V. Phone/Fax

Practice location:
  • Phone: 402-812-6874
  • Fax:
Mailing address:
  • Phone: 402-812-6874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: