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General NPI Number Information
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NPI Number | 1740813799
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Entity Type | Organization
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Legal Business Name | GINA MENDEZ A LICENSED CLINICAL SOCIAL WORKER P.C.
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 31045 TEMECULA PKWY STE 115
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City | TEMECULA
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State | CA
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Zip | 92592-3085
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Country | US
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Telephone | 951-963-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 31045 TEMECULA PKWY
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City | TEMECULA
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State | CA
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Zip | 92592-3085
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Country | US
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Telephone | 951-963-7445
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | GINA MENDEZ
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Credential |
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Telephone | 951-855-4967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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