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

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

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

• Alejandra D Mendizabal FNP

  • 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"
        }
    ]
}

• Maxcare Comfort
• Maydads Medical Supply
• Mehran Fakheri DMD a Professional Dental Corporation
• Mehran Javaherian
• Dianne Margaret Melicor, RN
• Valinda Summer Meneses
• Michael Vincent Laureola DDS Inc
• Shahram Moghadasi, PA
• Msa Pharmaceutical Services Corporation
• Nancy Elizabeth Munoz de Henriquez, FNP

• 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.