Provider Demographics
NPI:1992494017
Name:MENDOZA, SKYLA HAILY (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SKYLA
Middle Name:HAILY
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:SKYLA
Other - Middle Name:HAILY
Other - Last Name:NEUHARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:717 E EL CAMINO REAL STE 5
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2963
Mailing Address - Country:US
Mailing Address - Phone:408-228-3700
Mailing Address - Fax:
Practice Address - Street 1:717 E EL CAMINO REAL STE 5
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2963
Practice Address - Country:US
Practice Address - Phone:408-228-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2024-03-19
Deactivation Date:2023-07-17
Deactivation Code:
Reactivation Date:2023-08-02
Provider Licenses
StateLicense IDTaxonomies
CA95025051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily