Provider Demographics
NPI:1689475410
Name:MENDEZ, SANDRA JEANNETT (ACSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEANNETT
Last Name:MENDEZ
Suffix:
Gender:
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15660 LAS POSAS DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-1990
Mailing Address - Country:US
Mailing Address - Phone:714-492-3929
Mailing Address - Fax:
Practice Address - Street 1:23301 DRACAEA AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3201
Practice Address - Country:US
Practice Address - Phone:951-571-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical