| Doctor Name: | MS. CONNIE R MENDEZ |
| NPI Number: | 1659359388 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 19905 |
| Business Practice Address: | 2525 Lake Park Blvd West Valley, UT - 841208230 |
| Business Phone Number: | 8019823038 |
| Business Fax Number: | |
| Mailing Address: | 2525 Lake Park Blvd, WEST VALLEY |
| State: | UT |
| Postal Code: | 841208230 |
| Phone Number: | 8019823038 |
| Fax Number: | |
| NPI Enumeration Date: | 01/03/2006 |
| NPI Last Update Date: | 07/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 19905 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |