Provider Demographics
NPI:1740607837
Name:RODRIGUEZ-MENDOZA, MELINDA (FNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:RODRIGUEZ-MENDOZA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1444 E MCWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-3849
Mailing Address - Country:US
Mailing Address - Phone:626-636-5854
Mailing Address - Fax:
Practice Address - Street 1:1444 E MCWOOD ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791
Practice Address - Country:US
Practice Address - Phone:626-636-5854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily