Provider Demographics
NPI:1821317371
Name:MENDOZA, SHANA MARIE (MSW, MPH)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:MARIE
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10803 HOPE ST STE B
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5229
Mailing Address - Country:US
Mailing Address - Phone:714-226-2783
Mailing Address - Fax:818-830-6924
Practice Address - Street 1:10803 HOPE ST STE B
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5229
Practice Address - Country:US
Practice Address - Phone:714-226-2783
Practice Address - Fax:818-830-6924
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker