Active NPI
Lydia Esther Mendoza
- Behavior Analyst
- Lake Elsinore, CA
National Provider Identifier
1437734183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 4099 Elderberry RDG
Lake Elsinore, CA 92530-2044 - Phone
- (562) 341-5754
- NPI assigned
- Mar 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
4099 Elderberry RDG
Lake Elsinore, CA 92530-2044
Mailing address
3186 Airway Ave # Atea
Costa Mesa, CA 92626-4650
Phone (714) 881-0427
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": "1615766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615766400000",
"number": "1437734183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3186 AIRWAY AVE # ATEA",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264650",
"telephone_number": "714-881-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4099 ELDERBERRY RDG",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925302044",
"telephone_number": "562-341-5754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "LYDIA",
"middle_name": "ESTHER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-15",
"last_updated": "2021-03-15",
"certification_date": "2021-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.