Individual provider Active NPI

Rachel Marie Mendoza, PA-C

  • Physician Assistant
  • Lompoc, CA
National Provider Identifier
1316196322
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19915 Issued in CA
Practice address
217 W Central Ave Ste G
Lompoc, CA 93436-2830
Phone
(805) 735-4292
Fax
(805) 735-4293
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19915 CA Primary

Addresses

Primary practice location

217 W Central Ave Ste G
Lompoc, CA 93436-2830

Mailing address

217 W Central Ave Ste G
Lompoc, CA 93436-2830
Phone (805) 735-4292

Other practice location 1

1102 E Clark Ave Ste 120A
Santa Maria, CA 93455-5175
Phone (805) 332-8185

Other practice location 2

1992 Old Mission Dr Ste 140
Solvang, CA 93463-2302
Phone (805) 614-5690

Other practice location 3

2271 S Depot St
Santa Maria, CA 93455-1216
Phone (805) 922-0561

Other practice location 4

877 Oak Park Blvd
Pismo Beach, CA 93449-3292
Phone (805) 474-8450

Other practice location 5

5920 West Mall
Atascadero, CA 93422-4232
Phone (805) 466-0676

Other identifiers 2

IdentifierTypeStateIssuer
1084058OtherCATHE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT
19915OtherCACALIFORNIA STATE PHYSICIAN ASSISTANT LICENSE

Other names 1

  • Mrs. Rachel Marie Craig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081103000494 CA Practitioner - Physician Assistant 8921167131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

117 W Bunny Ave
Santa Maria, CA 93458-2805
Phone (805) 739-3890

1510 E Main St
Suite 104 C
Santa Maria, CA 93454-4825
Phone (805) 349-8514

217 W Central Ave
Suite G
Lompoc, CA 93436-2830
Phone (805) 735-4292

Hospital & facility affiliations

  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • Lompoc Valley Medical Center Hospital, Lompoc, CA, CCN 050110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19915CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Oct 30, 2017 Accepting new patients
Sansum Clinic CurrentSince Oct 9, 2014 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Oct 30, 2017 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

5920 West Mall
Atascadero, CA 93422
Phone (805) 466-0676

217 W Central Ave
Ste G
Lompoc, CA 93436
Phone (805) 735-4292

877 Oak Park Blvd
Pismo Beach, CA 93449
Phone (805) 473-2200

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

1400 E Church St
Ofc
Santa Maria, CA 93454
Phone (805) 739-3112

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1102 E Clark Ave
Ste 120A
Santa Maria, CA 93455
Phone (805) 332-8185

2271 S Depot St
Santa Maria, CA 93455
Phone (805) 922-0561

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1316196322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W CENTRAL AVE STE G",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934362830",
            "telephone_number": "805-735-4292",
            "fax_number": "805-735-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CENTRAL AVE STE G",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934362830",
            "telephone_number": "805-735-4292",
            "fax_number": "805-735-4293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 E Clark Ave Ste 120A",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934555175",
            "country_code": "US",
            "telephone_number": "805-332-8185",
            "fax_number": "805-332-8186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1992 Old Mission Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Solvang",
            "state": "CA",
            "postal_code": "934632302",
            "country_code": "US",
            "telephone_number": "805-614-5690",
            "fax_number": "805-614-5691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2271 S Depot St",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934551216",
            "country_code": "US",
            "telephone_number": "805-922-0561",
            "fax_number": "805-922-0083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "877 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493292",
            "country_code": "US",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5920 West Mall",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934224232",
            "country_code": "US",
            "telephone_number": "805-466-0676",
            "fax_number": "805-466-4862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT",
            "identifier": "1084058",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE PHYSICIAN ASSISTANT LICENSE",
            "identifier": "19915",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "CRAIG",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.