Individual provider Active NPI

Quinton R Mendoza

  • Behavior Technician
  • Vallejo, CA
National Provider Identifier
1295330934
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237
Phone
(707) 553-1784
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237

Mailing address

2112 Southwood Dr
Vacaville, CA 95687-6255
Phone (707) 772-7750

Other practice location 1

8801 Folsom Blvd Ste 195
Sacramento, CA 95826-3231
Phone (916) 382-4447

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

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1295330934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 SOUTHWOOD DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956876255",
            "telephone_number": "707-772-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917237",
            "telephone_number": "707-553-1784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8801 Folsom Blvd Ste 195",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958263231",
            "country_code": "US",
            "telephone_number": "916-382-4447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "QUINTON",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.