Provider Demographics
NPI:1811376940
Name:NATALI-MENDOZA, ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:NATALI-MENDOZA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-4403
Mailing Address - Country:US
Mailing Address - Phone:530-520-6630
Mailing Address - Fax:480-821-1887
Practice Address - Street 1:127 HOSPITAL DR STE 101
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2500
Practice Address - Country:US
Practice Address - Phone:707-552-8795
Practice Address - Fax:707-552-9638
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433192251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic