Jackeelyn Mendoza

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

125203 Issued in CA

Practice address

6267 Variel Ave
Woodland Hills, CA 91367-2512

Phone

(818) 657-0411

NPI assigned

Mar 6, 2018

Last updated

Oct 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridges Comm Treatment SVS.Inc.

  dba BRIDGES, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • El Monte, CA
  • NPI 1346374477
  NPD (past)

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1457853343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E ARROW HWY",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6267 VARIEL AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913672512",
            "telephone_number": "818-657-0411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 E Arrow Hwy",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917733319",
            "country_code": "US",
            "telephone_number": "909-260-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JACKEELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Noemy Mendez, LMFT, CST, CST-S
• Sergio Enrique Mendoza Sida, MD
• Ailen Alondra Mendoza
• Atenas Margarita Mendoza
• Dianne Mendoza
• Jesica Alejandre Mendoza
• Jessica Mendoza
• Madison Mendoza
• Marilyn Valeria Mendoza
• Marissa Irene Mendoza

• Marriage & Family Therapist in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.