Individual provider Active NPI

Vanessa Allison Mendoza

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1154029098
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62340 Issued in CA
Practice address
1100 W Town and Country Rd Ste 1300
Orange, CA 92868-4654
Phone
(855) 434-7763
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA62340 CA Primary

Addresses

Primary practice location

1100 W Town and Country Rd Ste 1300
Orange, CA 92868-4654

Mailing address

1100 W Town and Country Rd Ste 1300
Orange, CA 92868-4654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516002412 CA Practitioner - Physician Assistant 0547626673

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2592 N Santiago Blvd
Orange, CA 92867-1862

Hospital & facility affiliations

  • Apex Home Health Care Services Home health agency, Santa Ana, CA, CCN 058341
  • Remedy Home Health Care Home health agency, Northridge, CA, CCN 059162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
62340CAMDPharmacist
PA62340CAMDPhysician Assistant

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1154029098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684654",
            "telephone_number": "855-434-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "VANESSA",
        "middle_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.