Provider Demographics
NPI:1780826248
Name:MENDOZA, ALEJANDRO EDUARDO
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:EDUARDO
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 1:4460 N ILA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-1332
Mailing Address - Country:US
Mailing Address - Phone:559-999-3397
Mailing Address - Fax:
Practice Address - Street 1:4460 N ILA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-1332
Practice Address - Country:US
Practice Address - Phone:559-999-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor