Provider Demographics
NPI:1275600678
Name:MENDEZ, EMILY (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-1647
Mailing Address - Country:US
Mailing Address - Phone:650-219-6765
Mailing Address - Fax:
Practice Address - Street 1:5208 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-1647
Practice Address - Country:US
Practice Address - Phone:650-219-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52543106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist