Provider Demographics
NPI:1235376450
Name:GARDNER-MENDOZA, VERONICA BRIANA (LCSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:BRIANA
Last Name:GARDNER-MENDOZA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E VALENCIA AVE APT R
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2657
Mailing Address - Country:US
Mailing Address - Phone:818-470-8302
Mailing Address - Fax:
Practice Address - Street 1:305 E VALENCIA AVE APT R
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2657
Practice Address - Country:US
Practice Address - Phone:818-470-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker