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General NPI Number Information
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NPI Number | 1639711450
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Entity Type | Individual
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Provider Name | ALEXANDRA ROUELLE MENDOZA NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 3941 SAN DIMAS ST STE 101
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City | BAKERSFIELD
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State | CA
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Zip | 93301-5711
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Country | US
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Telephone | 661-864-7944
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Fax |
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Provider Business Mailing Address
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Address Line | 5128 EDERIA WAY
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City | BAKERSFIELD
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State | CA
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Zip | 93313
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Country | US
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Telephone | 661-865-9963
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95013055
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License Number State | CA
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