Active NPI
Lourdes Fausto Mendoza
- Social Worker
- Santa Fe Springs, CA
National Provider Identifier
1023612686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW124595
- Practice address
- 11741 Telegraph Rd
Santa Fe Springs, CA 90670-3681 - Phone
- (562) 949-8455
- NPI assigned
- Nov 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Rehabilitation Practitioner | 225400000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | ||
| Social Worker | 104100000X | ASW124595 | Primary |
Addresses
Primary practice location
11741 Telegraph Rd
Santa Fe Springs, CA 90670-3681
Mailing address
11741 Telegraph Rd Ste Ab&C
Santa Fe Springs, CA 90670-3681
Phone (562) 949-8455
Other practice location 1
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 221-6336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Clinics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Ontario, CA
- NPI 1902273923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1023612686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11741 TELEGRAPH RD STE AB&C",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906703681",
"telephone_number": "562-949-8455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11741 TELEGRAPH RD",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906703681",
"telephone_number": "562-949-8455"
}
],
"practiceLocations": [
{
"address_1": "1501 Hughes Way Ste 150",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908101878",
"country_code": "US",
"telephone_number": "310-221-6336",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENDOZA",
"first_name": "LOURDES",
"middle_name": "FAUSTO",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-24",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": "ASW124595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.