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General NPI Number Information
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NPI Number | 1598296402
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Entity Type | Individual
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Provider Name | LAURA YVETTE MENDEZ MA
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Gender | Female
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 18646 OXNARD ST
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City | TARZANA
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State | CA
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Zip | 91356-1411
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Country | US
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Telephone | 888-777-8565
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Fax |
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Provider Business Mailing Address
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Address Line | 11178 CULVER BLVD APT 4
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City | CULVER CITY
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State | CA
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Zip | 90230-4031
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Country | US
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Telephone | 805-402-8155
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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 |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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