Mayra Olivia Mendoza, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113834 Issued in CA

Practice address

2101 Tenaya Dr
Modesto, CA 95354-3930

Phone

(209) 722-4842

NPI assigned

Jul 16, 2018

Last updated

Jan 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mayra Olivia Torres Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Westley, CA
  • NPI 1770568347
  NPD
• Aspiranet-Merced Office

  • Case Management Agency
  • Merced, CA
  • NPI 1427762772
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1164908919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CUSTOMER CARE WAY",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953015167",
            "telephone_number": "209-722-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 TENAYA DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953543930",
            "telephone_number": "209-722-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MAYRA",
        "middle_name": "OLIVIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYRA",
            "last_name": "TORRES",
            "middle_name": "OLIVIA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriela Mendoza
• Jamie Mendoza
• Jesica Mendoza
• Kayla Mendoza
• Mayra Mendoza
• Sabrina Mendoza
• Vanessa Marie Mendoza, LVN
• Yesenia Mendoza
• Joshua Montero Meneses, DO
• Yan Meng, M.D.

• Clinical Social Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.