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NPI Code Detail

MEDICARE: MR. ARGENIS ALBERTO MENDOZA PMHNP-BC

MEDICARE: MR. ARGENIS ALBERTO MENDOZA PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner95026874CA
2163W00000XRegistered Nurse95175469CA

General Provider Information

NPI Number : 1114639911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ARGENIS ALBERTO MENDOZA PMHNP-BC
Provider Business Mailing Address
First Line : 2300 BOSWELL RD STE 275
Second Line :
City : CHULA VISTA
State : CA
Zip : 91914-3557
Country : US
Telephone Number : 858-279-1223
Fax Number :
Provider Business Practice Location Address
First Line : 3631 S HARBOR BLVD STE 200
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-7936
Country : US
Telephone Number : 657-356-6490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2022
Last Update Date : 12/02/2025

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