Gabriel Victor Mendonca de Souza

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2220 Broadway
San Diego, CA 92102-1926

Phone

(619) 232-8126

NPI assigned

May 19, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1225651722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 BROADWAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021926",
            "telephone_number": "619-232-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 BROADWAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021926",
            "telephone_number": "619-232-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDONCA DE SOUZA",
        "first_name": "GABRIEL",
        "middle_name": "VICTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa M. Mendivil, MSW, CADTP
• Ivan Mendivil
• Vicente Rafael Mendivil
• Minerva Lacra Mendizabal
• Alvin Mendlovits
• Jose Manuel Mendoza Alba
• Leslie Mendoza Corona
• Alejandra Mendoza Diaz
• Wenddy Mendoza Martinez
• Rebekah Mendoza Mihas

• Case Manager/Care Coordinator in San Diego, CA
• Providers in San Diego, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.