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Provider Information for 1780177915


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SANDRA F JONES-MENDOZA LMFT


Sex: Female

NPI: 1780177915
Last Updated: 2018-06-16
Certification Date:

Details

NameValue
NPI1780177915
Enumeration Date2018-06-12
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1020 GEORGETOWN AVE
TURLOCK, CA 95382-0836
United States

Phone: 209-613-7097 | Fax:
 
Primary Practice Address 21 N EL CIRCULO AVE
PATTERSON, CA 95363-2535
United States

Phone: 209-892-5902 | Fax:209-892-7846
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)CA20793Board of Behavioral Sciences
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 193400000X - Single Specialty Group
101YM0800X - Counselor - Mental Health
CA20793