MEDICARE: YOCELIN CECILIA CRUZ MENDOZA I

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
1	374U00000X	Home Health Aide	HHA200005732	DC

General Provider Information

NPI Number	:	1629557434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOCELIN CECILIA CRUZ MENDOZA I

Provider Business Mailing Address
First Line	:	1636 KENYON ST NW APT 207
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2726
Country	:	US
Telephone Number	:	301-955-6385
Fax Number	:

Provider Business Practice Location Address
First Line	:	4003 ELLIS ST
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-5754
Country	:	US
Telephone Number	:	202-751-5604
Fax Number	:	202-751-5604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2018
Last Update Date	:	02/02/2026

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