Provider Demographics
NPI:1891938387
Name:MENDOZA, SHEILA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:MAGLALANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 JEANELL DR
Mailing Address - Street 2:APT. 105
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-2159
Mailing Address - Country:US
Mailing Address - Phone:702-569-9043
Mailing Address - Fax:
Practice Address - Street 1:250 JEANELL DR
Practice Address - Street 2:APT. 105
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-2159
Practice Address - Country:US
Practice Address - Phone:702-569-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV08-0061225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist