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General NPI Number Information
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NPI Number | 1447768288
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Entity Type | Individual
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Provider Name | ROSALILIA M MENDOZA
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Gender | Female
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 6400 LAUREL CANYON BLVD STE 500
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1562
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Country | US
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Telephone | 818-901-6376
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 LAUREL CANYON BLVD STE 500
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1562
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Country | US
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Telephone | 818-901-6376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3183
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License Number State | CA
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