Provider Demographics
NPI:1053603647
Name:MENDOZA, FRANCISCA (MS PPS)
Entity type:Individual
Prefix:MS
First Name:FRANCISCA
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MS PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 MALABAR ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-2829
Mailing Address - Country:US
Mailing Address - Phone:323-767-3559
Mailing Address - Fax:
Practice Address - Street 1:6101 MALABAR ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-2829
Practice Address - Country:US
Practice Address - Phone:323-767-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090206389103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist