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NPI Code Detail

MEDICARE: LYDIA ESTHER MENDOZA

MEDICARE:   LYDIA ESTHER MENDOZA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1437734183
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA ESTHER MENDOZA
Provider Business Mailing Address
First Line : 3186 AIRWAY AVE # ATEA
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-4650
Country : US
Telephone Number : 714-881-0427
Fax Number :
Provider Business Practice Location Address
First Line : 4099 ELDERBERRY RDG
Second Line :
City : LAKE ELSINORE
State : CA
Zip : 92530-2044
Country : US
Telephone Number : 562-341-5754
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2021
Last Update Date : 03/15/2021

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Directions to “ LYDIA ESTHER MENDOZA ” Practice Location

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