Individual provider Active NPI

Elvia F Mendez, MSW, LCSW

  • Clinical Social Worker
  • Truckee, CA
National Provider Identifier
1235833716
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117137 Issued in CA
Practice address
10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234
Phone
(415) 424-4266
Fax
(415) 520-6633
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-4974 HI
Clinical Social Worker 1041C0700X 117137 CA Primary

Addresses

Primary practice location

10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234

Mailing address

8300 Esters Blvd Ste 900
Irving, TX 75063-2233
Phone (415) 424-4266

Other practice location 1

500 Ala Moana Blvd Ste 7400
Honolulu, HI 96813-4902
Phone (415) 424-4266

Other identifiers 1

IdentifierTypeStateIssuer
005673MedicaidHI

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

State licenses

LicenseStateTypeSpecialty
117137CAMDClinical Social Worker
LCSW-4974HIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1235833716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 ESTERS BLVD STE 900",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632233",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10775 PIONEER TRL STE 215",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961610234",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Ala Moana Blvd Ste 7400",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968134902",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "ELVIA",
        "middle_name": "F",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-4974",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "117137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005673",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.