Provider Demographics
NPI:1417092388
Name:MENDOZA, OSKAR J
Entity Type:Individual
Prefix:MR
First Name:OSKAR
Middle Name:J
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728-3235
Mailing Address - Country:US
Mailing Address - Phone:559-486-6080
Mailing Address - Fax:559-486-7768
Practice Address - Street 1:1204 W SHAW AVE # 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3706
Practice Address - Country:US
Practice Address - Phone:559-681-1947
Practice Address - Fax:559-486-7768
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)