Provider Demographics
NPI:1033657234
Name:URQUIZA MENDOZA, YAMILKA (PSYD IN MFT)
Entity Type:Individual
Prefix:DR
First Name:YAMILKA
Middle Name:
Last Name:URQUIZA MENDOZA
Suffix:
Gender:F
Credentials:PSYD IN MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10065 OLD GROVE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1664
Mailing Address - Country:US
Mailing Address - Phone:239-877-2039
Mailing Address - Fax:
Practice Address - Street 1:10065 OLD GROVE RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1664
Practice Address - Country:US
Practice Address - Phone:239-877-2039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112227106H00000X
CAIMF95606101YM0800X, 390200000X
CALMFT112227103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program