ANGELICA MENDOZA (NPI# 1699399634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699399634 |
Entity Type | Individual |
Full Name | ANGELICA MENDOZA |
Credential | MEDICAL ASSISTANT |
Practice Address |
1628 Broadway St Vallejo CA 94590-2405 |
Practice Telephone | 7076498300 |
Practice Fax Number | 7076498302 |
Mailing Telephone | 7076498300 |
Mailing Fax Number | 7076498302 |
Enumeration Date | 2020-06-05 |
Last Update Date | 2020-06-05 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246Z00000X | Specialist/Technologist, Other | B4K5W6G8 | CA | Technologists, Technicians & Other Technical Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760985238 | Angelica Mendoza | Behavior Technician | 510 Whispering Wind Dr Ste 110, Tracy, CA 95377-8119 | 2018-03-12 |
1902158322 | Angelica Mendoza | Speech-Language Pathologist | 4 Railroad Ave, Somerset, NJ 08873-2724 | 2012-10-09 |
Street Address |
1628 BROADWAY ST |
City | VALLEJO |
State | CA |
Zip Code | 94590-2405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730391319 | Rashid Akbar Islam | Legal Medicine | 1628 Broadway St, Vallejo, CA 94590 | 2007-05-04 |
1467076497 | William Arthur Joyce | Licensed Vocational Nurse | 1628 Broadway St, Vallejo, CA 94590-2405 | 2020-06-05 |
1245853399 | Puneet Grewal | Licensed Vocational Nurse | 1628 Broadway St, Vallejo, CA 94590-2405 | 2020-05-23 |
1215550306 | Aminah Him | Licensed Vocational Nurse | 1628 Broadway St, Vallejo, CA 94590-2405 | 2020-05-22 |
1164955530 | Marquita King | Counselor | 1628 Broadway St, B, Vallejo, CA 94590-2405 | 2017-04-04 |
1912451410 | Stephanie Dorsey | Counselor | 1628 Broadway St, Vallejo, CA 94590-2405 | 2016-08-12 |
1790149672 | Sheila Kennedy | Counselor | 1628 Broadway St, Vallejo, CA 94590-2405 | 2016-04-07 |
1235596073 | Latisha Calhoun | Counselor | 1628 Broadway St, Vallejo, CA 94590-2405 | 2016-01-25 |
1932446028 | Samuel Eric Patterson | Counselor | 1628 Broadway St, B, Vallejo, CA 94590-2405 | 2013-01-09 |
1548505639 | Medmark Treament Services | Clinic/Center | 1628 Broadway St, Vallejo, CA 94590-2405 | 2012-11-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265051445 | Jaspreet Bains | Licensed Vocational Nurse | 508 Alabama Street, Vallejo, CA 94590 | 2020-04-08 |
1467097527 | Deneane Hannon | Behavioral Analyst | 238 Georgia St. Ste 102, Vallejo, CA 94590 | 2019-11-13 |
1780243196 | Abla Harara Almoraissi | Health Educator | John F. Kennedy Library, 505 Santa Clara St, Vallejo, CA 94590 | 2019-06-10 |
1891264461 | Brian Emory Kellogg | Marriage & Family Therapist | 525 Oregon St., Php/iop, Vallejo, CA 94590 | 2018-11-13 |
1952801862 | Carica Theresa Saraza Macariola | Specialist/Technologist | 1007 Solano Avenue, Vallejo, CA 94590 | 2018-02-16 |
1770007973 | Deborah A Johnson-white | Licensed Vocational Nurse | 908 Tuolumne, Vallejo, CA 94590 | 2017-07-29 |
1306378260 | Edgar Diaz | Counselor | 236 Georgia Street Suite 101, Vallejo, CA 94590 | 2017-03-30 |
1528440096 | Soren Perry | Counselor | 236 Georgia St., Vallejo, CA 94590 | 2015-06-22 |
1518366327 | Kimberly A Holland | Counselor | 631 Tennessee Street Suite 201, Vallejo, CA 94590 | 2014-08-18 |
1841605193 | Lawana Lofton | Psychologist | 88 Valle Vista Drive, Unit 6310, Vallejo, CA 94590 | 2014-06-25 |
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Taxonomy Code | 246Z00000X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619590528 | Brain Training Institute LLC | Specialist/Technologist, Other | 100 Pierre Rd Ste A, Walnut, CA 91789-2565 | 2020-05-26 |
1063050441 | Medical Legal Experts Mle | Specialist/Technologist, Other | 4623 Hawthorne Blvd., Suite 401, Lawndale, CA 90260 | 2019-12-16 |
1720632045 | Amanda M Vanderford | Specialist/Technologist, Other | 6150 Tule Lane, Foresthill, CA 95631 | 2019-07-25 |
1730655408 | Linda Adkins | Specialist/Technologist, Other | 515 W 6th St Fl 9, Los Angeles, CA 90014-1201 | 2018-10-19 |
1346741576 | Yasmin Ali | Specialist/Technologist, Other | 41019 Woodshire Dr, Palmdale, CA 93551-5746 | 2018-02-22 |
1669971164 | Timothy Michael Dwyer Jr. | Specialist/Technologist, Other | 3225 S Townsend St, Santa Ana, CA 92704-6647 | 2018-02-09 |
1801305503 | Judee H Carrico | Specialist/Technologist, Other | 2032 Thompson Ct Ste 12, Montrose, CA 91020-1652 | 2017-09-25 |
1033659388 | Morgan Irene Gilfillan | Specialist/Technologist, Other | 1420 Hornblend St, Apt. 1, San Diego, CA 92109-4329 | 2017-03-06 |
1992245427 | Jennifer Mcevoy | Specialist/Technologist, Other | 355 1st St Unit S805, San Francisco, CA 94105-3067 | 2017-03-02 |
1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
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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.