Provider Demographics
NPI:1265937510
Name:MENDOZA, STACEY (MS, ATC, EMT-B, CSCS)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MS, ATC, EMT-B, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 N REED AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2017
Mailing Address - Country:US
Mailing Address - Phone:559-494-3000
Mailing Address - Fax:
Practice Address - Street 1:995 N REED AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2017
Practice Address - Country:US
Practice Address - Phone:559-638-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer