Provider Demographics
NPI:1407281561
Name:PICKER, CHRISTINA MENDOZA
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MENDOZA
Last Name:PICKER
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 1:11704 SIENA MIST AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-3008
Mailing Address - Country:US
Mailing Address - Phone:559-302-7427
Mailing Address - Fax:
Practice Address - Street 1:2415 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4009
Practice Address - Country:US
Practice Address - Phone:559-302-7427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-2021251041C0700X
CA883961041C0700X
MN310711041C0700X
NV7486-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical