Doctor Name: | ANTHONY MENDOZA |
NPI Number: | 1477670909 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PT27140 |
Business Practice Address: | 30 Flory Ave Moorpark, CA - 930211815 |
Business Phone Number: | 8055322641 |
Business Fax Number: | |
Mailing Address: | 30 Flory Ave, MOORPARK |
State: | CA |
Postal Code: | 930211815 |
Phone Number: | 8055322641 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | PT27140 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |