Provider Demographics
NPI:1659872711
Name:MENDOZA, MATTHEW CHRISTIAN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CHRISTIAN
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15071 HORNELL ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-2121
Mailing Address - Country:US
Mailing Address - Phone:702-401-6860
Mailing Address - Fax:626-988-4259
Practice Address - Street 1:15071 HORNELL ST
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2121
Practice Address - Country:US
Practice Address - Phone:702-401-6860
Practice Address - Fax:626-988-4259
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2023-01-30
Deactivation Date:2018-02-26
Deactivation Code:
Reactivation Date:2018-03-08
Provider Licenses
StateLicense IDTaxonomies
CA125459106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist