Provider Demographics
NPI:1184896284
Name:MENDOZA, CLAUDIA CRISTINA (PA-C)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:CRISTINA
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 CHURCH ST N STE 103
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4373
Mailing Address - Country:US
Mailing Address - Phone:704-333-0465
Mailing Address - Fax:704-333-0466
Practice Address - Street 1:845 CHURCH ST N STE 103
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4373
Practice Address - Country:US
Practice Address - Phone:704-333-0465
Practice Address - Fax:704-333-0466
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001001312363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2759287Medicare PIN