Provider Demographics
NPI:1376165878
Name:MENDOZA-PINEDA, ZEIDY JULISSA (FNP)
Entity Type:Individual
Prefix:
First Name:ZEIDY
Middle Name:JULISSA
Last Name:MENDOZA-PINEDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ZEIDY
Other - Middle Name:
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:20707 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1526
Mailing Address - Country:US
Mailing Address - Phone:310-719-1380
Mailing Address - Fax:
Practice Address - Street 1:801 N HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1810
Practice Address - Country:US
Practice Address - Phone:714-774-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013398363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care