=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376328443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARICELA MENDEZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2023
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7415 HENRIETTA DR
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95822-5142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-520-7399
-----------------------------------------------------
Fax | 916-520-7398
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7415 HENRIETTA DR
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95822-5142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-520-7399
-----------------------------------------------------
Fax | 916-520-7398
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 372600000X
-----------------------------------------------------
Taxonomy Name | Adult Companion
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------