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NPI Code Detail

MEDICARE: MINERVA F NUNEZ MENDEZ ASW

MEDICARE: MINERVA F NUNEZ MENDEZ ASW
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
11041C0700XClinical Social WorkerCA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1770850265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINERVA F NUNEZ MENDEZ ASW
Provider Business Mailing Address
First Line : 2420 MARTIN RD STE 200
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-8610
Country : US
Telephone Number : 707-399-4520
Fax Number : 707-399-4521
Provider Business Practice Location Address
First Line : 2420 MARTIN RD STE 200
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-8610
Country : US
Telephone Number : 707-399-4520
Fax Number : 707-399-4521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2011
Last Update Date : 03/22/2017

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