Provider Demographics
NPI:1457244477
Name:MENDEZ, ALYSSA MARIE (AMFT)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:MARIE
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:MARIE
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:PO BOX 7936
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-7936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 E JANSS RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2133
Practice Address - Country:US
Practice Address - Phone:805-497-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist