Provider Demographics
NPI:1114639911
Name:MENDOZA, ARGENIS ALBERTO (PMHNP)
Entity type:Individual
Prefix:
First Name:ARGENIS
Middle Name:ALBERTO
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 3RD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5786
Mailing Address - Country:US
Mailing Address - Phone:619-759-1548
Mailing Address - Fax:
Practice Address - Street 1:629 3RD AVE STE B
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5786
Practice Address - Country:US
Practice Address - Phone:619-759-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026874363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health