Roberto Mendoza Astudillo

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Practice address

114 S Delaware St
San Mateo, CA 94401-3222

Phone

(650) 579-7881

Fax

(650) 579-2640

NPI assigned

Dec 3, 2020

Last updated

Dec 3, 2020By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Not 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.

• Caminar

  dba Project Ninety 247A

  • Substance Abuse Rehabilitation Facility
  • San Mateo, CA
  • NPI 1164853644
  NPD
• Caminar

  dba Project Ninety Kleinheinz House

  • Substance Abuse Rehabilitation Facility
  • San Mateo, CA
  • NPI 1215368253
  NPD (past)

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1619572997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S DELAWARE ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013222",
            "telephone_number": "650-579-7881",
            "fax_number": "650-579-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S DELAWARE ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013222",
            "telephone_number": "650-579-7881",
            "fax_number": "650-579-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTUDILLO",
        "first_name": "ROBERTO",
        "middle_name": "MENDOZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aishah Bibi Aslam
• Oriana Asoau
• Assent ABA LLC
• Assista Home Health Care LLC
• Assista Hospice Care LLC
• Christine Lechadores Atrero
• Elizabeth Atwood, PPS-C
• Diane Au, L.AC.
• Tina Au
• Suzanne Aubry

• Other Specialist/Technologist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Other Specialist/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.