Individual provider Active NPI

Laura Marie Weigand Mendoza, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1497209746
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291754 Issued in CA
Practice address
8080 Dagget St
San Diego, CA 92111-2333
Phone
(858) 395-3671
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 291754 CA Primary

Addresses

Primary practice location

8080 Dagget St
San Diego, CA 92111-2333

Mailing address

6217 Boulder Lake Ave Apt 105
San Diego, CA 92119-3301
Phone (818) 568-4087

Other names 1

  • Laura Marie Weigand Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1497209746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6217 BOULDER LAKE AVE APT 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921193301",
            "telephone_number": "818-568-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 DAGGET ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112333",
            "telephone_number": "858-395-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGAND MENDOZA",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WEIGAND",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.

Verify at the official NPI Registry.