MRS. MIRELLA MENDOZA (NPI# 1588165351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588165351 |
| Entity Type | Individual |
| Full Name | MRS. MIRELLA MENDOZA |
| Credential | NP |
| Practice Address |
122 E San Antonio Dr King City CA 93930 |
| Mailing Address |
122 E San Antonio Dr King City CA 93930-2518 |
| Practice Telephone | 8313855944 |
| Mailing Telephone | 8313855944 |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP95008981 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
A005537 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 E Southpointe Ave, Rogers, AR 727580505 | 4797153147 |
| Street Address |
122 E SAN ANTONIO DR |
| City | KING CITY |
| State | CA |
| Zip Code | 93930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073040937 | Jalia Tucker | Family Medicine | 122 E San Antonio Dr, King City, CA 93930-2518 | 2017-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841841202 | Carl Jorgensen | Pharmacist | Riteaid, 540 Canal Street, King City, CA 93930 | 2019-09-26 |
| 1750780284 | Kayla Noon | Counselor | 200 Broadway St., Suite 70, King City, CA 93930 | 2014-08-20 |
| 1831323906 | Tawfiq Imam | Pharmacist | 540 Canal St, Rite Aid Pharmacy #5880, King City, CA 93930 | 2009-05-05 |
| 1437510641 | Christina Sandoval | Counselor | 200 Broadway St, 70, King City, CA 93930 | 2016-03-15 |
| 1376920850 | Celia Trujillo | Counselor | 200 Broadway St, King City, CA 93930 | 2015-05-04 |
| 1497152078 | Nguyen Pham | Internal Medicine | 300 Canal St, King City, CA 93930 | 2014-11-26 |
| 1104171925 | Hassan Jadid | Internal Medicine | 300 Canal St, King City, CA 93930 | 2012-07-18 |
| 1821227422 | Jovanna M Velazquez | Technician, Other | 200 Broadway, Suite 88, King City, CA 93930 | 2009-07-06 |
| 1598961161 | Diane Lynn Hardy | Marriage & Family Therapist | 522 Broadway St, Suite D, King City, CA 93930 | 2007-06-21 |
| 1700901865 | James Francis Matthews | Pharmacist | 425 Broadway, King City, CA 93930 | 2007-03-20 |
| Find all providers in zip 93930 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710955406 | Debra C. Pankau | Nurse Practitioner | 305 Rhode Island, King City, MO 64463-0278 | 2006-03-09 |
| 1629310024 | Nancy Rivas | Nurse Practitioner | 404 S 1st St, King City, CA 93930-2947 | 2013-03-23 |
| 1467521922 | Barbara Corinne Pekema | Nurse Practitioner | 210 Canal St, King City, CA 93930-3432 | 2006-11-07 |
| 1598834053 | Alice Adella Gaunt | Nurse Practitioner | 1180 Broadway St, King City, CA 93930-3602 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003640 | Samira Kadri | Nurse Practitioner | 431 S Burnside Ave Apt 3g, Los Angeles, CA 90036-5343 | 2020-11-08 |
| 1801497706 | Ana Maria Cajigas De Jesus | Nurse Practitioner | 313 S Velva Pl, Anaheim, CA 92804-2647 | 2020-11-06 |
| 1609477421 | Taylor Mcknight | Nurse Practitioner | 5073 Oxford Dr, Cypress, CA 90630-3653 | 2020-11-06 |
| 1619578465 | Roslyn Dykes-barrow | Nurse Practitioner | 17631 Mulberry Dr, Carson, CA 90746-7403 | 2020-11-06 |
| 1861093601 | Philana P Mcdonald | Nurse Practitioner | 183 Stonebridge Ln, Paso Robles, CA 93446-1926 | 2020-11-06 |
| 1386245264 | Annie Parikh | Nurse Practitioner | 11675 Lambert Ave, El Monte, CA 91732-1955 | 2020-11-05 |
| 1073114096 | Blanca De Jesus Serrano | Nurse Practitioner | 18144 Outer Hwy 18 Ste 200, Apple Valley, CA 92307-2212 | 2020-11-05 |
| 1578164166 | Aimon Sangwanpanich | Nurse Practitioner | 8520 Shirley Ave, Northridge, CA 91324-4149 | 2020-11-02 |
| 1043810757 | Casie Lee Mcguire | Nurse Practitioner | 1826 Rainbow Terrace Ln, Montebello, CA 90640-1953 | 2020-10-30 |
| 1295335099 | Jail Lopez | Nurse Practitioner | 3171 Lynwood Rd, Lynwood, CA 90262-4118 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.