Provider Demographics
NPI:1992852560
Name:MENDOZA, CRISTINA NORMA
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:NORMA
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CRISTINA
Other - Middle Name:NORMA
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 E MINARETS AVE
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650-1239
Mailing Address - Country:US
Mailing Address - Phone:559-436-0482
Mailing Address - Fax:
Practice Address - Street 1:380 COALINGA PLZ
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-1704
Practice Address - Country:US
Practice Address - Phone:559-935-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125442106H00000X
CA95616106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist