Yedid Azaira Mondragon

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-KSQMDE Issued in CA

Practice address

649 E Albertoni St Ste 100
Carson, CA 90746-1538

Phone

(310) 436-9300

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Yedid Mendoza Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Star View Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Carson, CA
  • NPI 1750641445
  NPD (past)
• Star View Behavioral Health, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Carson, CA
  • NPI 1871678300

  Case Manager/Care Coordinator

  NPD (past)

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1285286641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 E ALBERTONI ST STE 100",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461538",
            "telephone_number": "310-436-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 E ALBERTONI ST STE 100",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461538",
            "telephone_number": "310-436-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDRAGON",
        "first_name": "YEDID",
        "middle_name": "AZAIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-KSQMDE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEDID",
            "last_name": "MENDOZA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gabriella Miller
• Julian Patrick Miller, DDS
• Tanya Miller, COTA/L
• Lan Thuy Milliken
• Reza Moghbel, DDS
• Yvonne Montes
• Steven Monti, PHARM.D.
• Charon Moody, RDHAP
• Melvin Medero Moore Jr., PH.D.
• Daisy Munoz

• Peer Specialist in Carson, CA
• Providers in Carson, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.