Provider Demographics
NPI:1760095707
Name:MENDEZ, ESTEFANY
Entity Type:Individual
Prefix:
First Name:ESTEFANY
Middle Name:
Last Name:MENDEZ
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 1:2281 HUNTINGTON POINT RD UNIT 142
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-3570
Mailing Address - Country:US
Mailing Address - Phone:703-338-1083
Mailing Address - Fax:
Practice Address - Street 1:855 3RD AVE STE 2230
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1350
Practice Address - Country:US
Practice Address - Phone:619-271-7992
Practice Address - Fax:619-271-7970
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist