Active NPI
Cecilia Mendoza
- Clinical Social Worker
- San Leandro, CA
National Provider Identifier
1619040797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 29452
- Practice address
- 2050 Fairmont Dr
San Leandro, CA 94578-1001 - Phone
- (510) 760-6611
- Fax
- (510) 483-4277
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 29452 | CA | Primary |
Addresses
Primary practice location
2050 Fairmont Dr
San Leandro, CA 94578-1001
Mailing address
2050 Fairmont Dr
San Leandro, CA 94578
Phone (510) 760-6611
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29452 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Family of Agencies | Past | Accepting new patients | |
| Seneca Family of Agencies | Past | Accepting new patients | |
| Rocketship Education Wisconsin Inc. | Past | Accepting new patients | |
| Seneca Center | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Fairfield, CA
- NPI 1699972281
-
- Community/Behavioral Health Agency
- Anaheim, CA
- NPI 1174801690
-
- Community/Behavioral Health Agency
- Santa Rosa, CA
- NPI 1205152733
-
- Local Education Agency (LEA)
- Milwaukee, WI
- NPI 1275964025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1619040797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 FAIRMONT DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94578",
"telephone_number": "510-760-6611",
"fax_number": "510-483-4277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 FAIRMONT DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781001",
"telephone_number": "510-760-6611",
"fax_number": "510-483-4277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "CECILIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "29452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.