Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003385907 |
---|---|
Provider Name | Veronica Mendoza |
First Address | Vista, CA 92081-6627 |
Second Address | Vista, CA 92081-6627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2018 |
Last Update Date | 20/11/2018 |