Provider Demographics
NPI:1205116316
Name:MENDICK, SAMEDI
Entity type:Individual
Prefix:
First Name:SAMEDI
Middle Name:
Last Name:MENDICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 581943
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7273 14TH AVE
Practice Address - Street 2:SUITE 120-B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-3500
Practice Address - Country:US
Practice Address - Phone:916-383-6784
Practice Address - Fax:916-383-8488
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical