Provider Demographics
NPI:1720644362
Name:MENDEZ, ROBIN LYNN
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:MENDEZ
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 1:3224 PLANTATION CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8717
Mailing Address - Country:US
Mailing Address - Phone:408-466-5033
Mailing Address - Fax:
Practice Address - Street 1:5404 KIERNAN AVE
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CA
Practice Address - Zip Code:95368-9130
Practice Address - Country:US
Practice Address - Phone:408-466-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA266649164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse