Individual provider Active NPI

Edric Mendoza

  • Behavior Technician
  • Lakewood, CA
National Provider Identifier
1336014646
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3217 Carson St # 1002
Lakewood, CA 90712-4006
Phone
(323) 792-2540
Fax
(562) 724-9887
NPI assigned
Oct 7, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 CA Primary

Addresses

Primary practice location

3217 Carson St # 1002
Lakewood, CA 90712-4006

Mailing address

3217 Carson St # 1002
Lakewood, CA 90712-4006
Phone (323) 792-2540

Other practice location 1

1077 Pacific Coast HWY
PMB 132
Seal Beach, CA 90740-6214
Phone (323) 792-2540

Other practice location 2

1403 Lomita Blvd Ste 304
Harbor City, CA 90710-2085
Phone (323) 792-2540

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": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1336014646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 CARSON ST # 1002",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907124006",
            "telephone_number": "323-792-2540",
            "fax_number": "562-724-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 CARSON ST # 1002",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907124006",
            "telephone_number": "323-792-2540",
            "fax_number": "562-724-9887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1077 Pacific Coast HWY",
            "address_2": "PMB 132",
            "address_purpose": "LOCATION",
            "city": "Seal Beach",
            "state": "CA",
            "postal_code": "907406214",
            "country_code": "US",
            "telephone_number": "323-792-2540",
            "fax_number": "562-724-9887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1403 Lomita Blvd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Harbor City",
            "state": "CA",
            "postal_code": "907102085",
            "country_code": "US",
            "telephone_number": "323-792-2540",
            "fax_number": "562-724-9887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "EDRIC",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.