Provider Demographics
NPI:1215713383
Name:MENDOZA, TERESITA GUADALUPE (MSW)
Entity type:Individual
Prefix:
First Name:TERESITA
Middle Name:GUADALUPE
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 SALINAS ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2717
Mailing Address - Country:US
Mailing Address - Phone:831-757-7915
Mailing Address - Fax:
Practice Address - Street 1:433 SALINAS ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2717
Practice Address - Country:US
Practice Address - Phone:831-757-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical