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NPI Code Detail

MEDICARE: JAQUELINE LIZZET MENDEZ

MEDICARE: JAQUELINE LIZZET MENDEZ
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
1101YP2500XProfessional Counselor21334CA
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family Therapist160065CA

General Provider Information

NPI Number : 1316520885
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAQUELINE LIZZET MENDEZ
Provider Business Mailing Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Provider Business Practice Location Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2021
Last Update Date : 04/20/2026

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Directions to “ JAQUELINE LIZZET MENDEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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