Provider Demographics
NPI:1629628250
Name:MENDES, WENDY EILEEN
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:EILEEN
Last Name:MENDES
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 1:42441 SHAW LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-7268
Mailing Address - Country:US
Mailing Address - Phone:951-543-7808
Mailing Address - Fax:
Practice Address - Street 1:42441 SHAW LN
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7268
Practice Address - Country:US
Practice Address - Phone:951-543-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider