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NPI Code Detail

MEDICARE: ANDREW MENDOZA

MEDICARE: ANDREW 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1700902426
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW MENDOZA
Provider Business Mailing Address
First Line : 500 AIRPORT WAY
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8500
Country : US
Telephone Number : 808-388-4230
Fax Number :
Provider Business Practice Location Address
First Line : 500 AIRPORT WAY
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8500
Country : US
Telephone Number : 808-388-4230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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Directions to “ ANDREW MENDOZA ” Practice Location

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