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General NPI Number Information
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NPI Number | 1750094413
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Entity Type | Individual
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Provider Name | MAYRA E MENDOZA LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 402 W BROADWAY STE 400
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City | SAN DIEGO
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State | CA
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Zip | 92101-3554
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Country | US
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Telephone | 866-478-3978
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22192
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City | BAKERSFIELD
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State | CA
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Zip | 93390-2192
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Country | US
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Telephone | 831-710-0783
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 126746
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License Number State | CA
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