Provider Demographics
NPI:1982789921
Name:MENDOZA-MCCOY, ANNETTE H (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:H
Last Name:MENDOZA-MCCOY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 MARICOPA HWY
Mailing Address - Street 2:A144
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3126
Mailing Address - Country:US
Mailing Address - Phone:805-280-5129
Mailing Address - Fax:831-855-0186
Practice Address - Street 1:693 KICKAPOO DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-4409
Practice Address - Country:US
Practice Address - Phone:805-280-5129
Practice Address - Fax:831-855-0186
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41523101YM0800X
CA41523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8581042Medicaid