Individual provider Active NPI

Carleen Rose Mendiola, LVN

  • General Acute Care Hospital
  • Elk Grove, CA
National Provider Identifier
1407907520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
224342 Issued in CA
Practice address
9821 Toscano Dr
Elk Grove, CA 95757-3029
Phone
(916) 686-8970
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 224342 CA Primary

Addresses

Primary practice location

9821 Toscano Dr
Elk Grove, CA 95757-3029

Mailing address

9821 Toscano Dr
Elk Grove, CA 95757-3029
Phone (916) 686-8970

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
224342CAMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407907520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 TOSCANO DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573029",
            "telephone_number": "916-686-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9821 TOSCANO DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573029",
            "telephone_number": "916-686-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "CARLEEN",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "224342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.