Provider Demographics
NPI:1346910346
Name:MENDEZ, SYDELCIS MAITTEE (LMFT)
Entity Type:Individual
Prefix:
First Name:SYDELCIS
Middle Name:MAITTEE
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 1:7660 BEVERLY BLVD APT 122
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2730
Mailing Address - Country:US
Mailing Address - Phone:347-344-3594
Mailing Address - Fax:
Practice Address - Street 1:7660 BEVERLY BLVD APT 122
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2730
Practice Address - Country:US
Practice Address - Phone:424-209-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122901106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist