Provider Demographics
NPI:1053893248
Name:MENDOZA, KRISTINE JOIE M
Entity type:Individual
Prefix:MRS
First Name:KRISTINE JOIE
Middle Name:M
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KRISTINE JOIE
Other - Middle Name:MALGAPO
Other - Last Name:GAJONERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2483 LOCHENSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-5900
Mailing Address - Country:US
Mailing Address - Phone:907-570-6208
Mailing Address - Fax:888-863-9346
Practice Address - Street 1:2483 LOCHENSHIRE PL
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-5900
Practice Address - Country:US
Practice Address - Phone:907-570-6208
Practice Address - Fax:888-863-9346
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management