Individual provider Active NPI

Susan Marie Mendoza, MS

  • Speech-Language Pathologist
  • Orange, CA
National Provider Identifier
1205158235
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8172 Issued in CA
Practice address
681 S Tustin St
Suite 110
Orange, CA 92866-3348
Phone
(714) 289-1418
Fax
(714) 782-7424
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8172 CA Primary

Addresses

Primary practice location

681 S Tustin St
Suite 110
Orange, CA 92866-3348

Mailing address

681 S Tustin St
Suite 110
Orange, CA 92866-3348
Phone (714) 289-1418

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8172CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Therapy Services Speech-Language Pathologist Current Accepting new patients
Synergy Speech Therapy Services Inc Current Accepting new patients

Locations

681 S Tustin St
Ste 110
Orange, CA 92866
Phone (714) 289-1418

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1205158235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 S TUSTIN ST",
            "address_2": "SUITE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663348",
            "telephone_number": "714-289-1418",
            "fax_number": "714-782-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 S TUSTIN ST",
            "address_2": "SUITE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663348",
            "telephone_number": "714-289-1418",
            "fax_number": "714-782-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "8172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.