Provider Demographics
NPI:1154161628
Name:MENDRIN, HANNAH B (CCLS)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:B
Last Name:MENDRIN
Suffix:
Gender:F
Credentials:CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1061 SIERRA AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1263
Mailing Address - Country:US
Mailing Address - Phone:562-458-1117
Mailing Address - Fax:
Practice Address - Street 1:9300 VALLEY CHILDRENS PL APT SUITE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8762
Practice Address - Country:US
Practice Address - Phone:562-458-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11237792080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics