Mutya Victoria Mendiola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115051 Issued in CA

Practice address

5965 Village Way # E105-185
San Diego, CA 92130-2475

Phone

(858) 722-9366

NPI assigned

Apr 4, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1437901170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 VILLAGE WAY # E105-185",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302475",
            "telephone_number": "858-722-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 VILLAGE WAY # E105-185",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302475",
            "telephone_number": "858-722-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "MUTYA",
        "middle_name": "VICTORIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Mendieta, M.ED
• Mending Matters
• Jacqueline Mendiola Garcia
• Maharlika Mendiola
• Malia Mendiola, OTR/L
• Alexa M. Mendivil, MSW, CADTP
• Ivan Mendivil
• Vicente Rafael Mendivil
• Minerva Lacra Mendizabal
• Alvin Mendlovits

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.