Jesus Danny Mendiola-Lopez

Individual provider Active NPI Behavior Technician · Shelton, WA

NPI 1164362000 · NPPES record last updated Mar 31, 2026

Key facts

NPI
1164362000
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
538 E Terrace View Dr
Shelton, WA 98584-1828
Phone
(360) 490-8067
NPI assigned
Mar 31, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

538 E Terrace View Dr
Shelton, WA 98584-1828

Mailing address

538 E Terrace View Dr
Shelton, WA 98584-1828

Other providers in Shelton, WA

All providers in Shelton, WA · Behavior Technician in Washington

Sources for this page

Verify at the official NPI Registry.