Alejandra Damayanti Mendizabal

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021415 Issued in CA

Practice address

9128 Woodman Ave
Arleta, CA 91331-6405

Phone

(818) 892-7795

Fax

(818) 892-7797

NPI assigned

Jul 14, 2022

Last updated

Aug 9, 2023By the provider in NPPES

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

Other names 1

• Alejandra Damayanti Mendizabal Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DJBBED/Endpoint/DJBBED
• FHIR API: https://fhir4.healow.com/fhir/r4/ECCGDD/Endpoint/ECCGDD

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.

• Alejandra D Mendizabal FNP

  dba Mi Salud Medical Clinic

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1366124034

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1487388443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10139 BEVIS AVE",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913452801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9128 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913316405",
            "telephone_number": "818-892-7795",
            "fax_number": "818-892-7797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9653 Alder Ave",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923356129",
            "country_code": "US",
            "telephone_number": "661-666-7238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDIZABAL",
        "first_name": "ALEJANDRA",
        "middle_name": "DAMAYANTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "UPDOX",
            "affiliation": "N",
            "endpointDescription": "EXCHANGE PATIENT INFORMATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9128 Woodman Ave",
            "city": "Arleta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913316405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "UPDOX",
            "affiliation": "N",
            "endpointDescription": "EXCHANGE PATIENT INFORMATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9653 Alder Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEJANDRA",
            "last_name": "MENDIZABAL",
            "middle_name": "DAMAYANTI",
            "credential": "DELGADILLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Arleta, CA
• Providers in Arleta, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.