Provider Demographics
NPI:1225339724
Name:MENDEZ, RAQUEL A
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:A
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S EL CIELO RD
Mailing Address - Street 2:SUITE E/F
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7926
Mailing Address - Country:US
Mailing Address - Phone:760-416-1753
Mailing Address - Fax:760-416-0263
Practice Address - Street 1:400 S EL CIELO RD
Practice Address - Street 2:SUITE E/F
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7926
Practice Address - Country:US
Practice Address - Phone:760-416-1753
Practice Address - Fax:760-416-0263
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health