Active NPI
Jasmine Mendoza, BCBA
- Behavior Analyst
- San Jose, CA
National Provider Identifier
1649632480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-40636
- Practice address
- 1485 Saratoga Ave Ste 100
San Jose, CA 95129-4965 - Phone
- (818) 241-6780
- Fax
- (818) 241-6853
- NPI assigned
- Mar 22, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Behavior Analyst | 103K00000X | 1-20-40636 | CA | Primary |
Addresses
Primary practice location
1485 Saratoga Ave Ste 100
San Jose, CA 95129-4965
Mailing address
PO Box 767938
Roswell, GA 30076-7938
Phone (818) 241-6780
Other practice location 1
251 Llewellyn Ave
Campbell, CA 95008-1940
Phone (408) 379-3790
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-20-40636 | Other | CA | BCBA |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1649632480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 767938",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300767938",
"telephone_number": "818-241-6780",
"fax_number": "818-241-6853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 SARATOGA AVE STE 100",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951294965",
"telephone_number": "818-241-6780",
"fax_number": "818-241-6853"
}
],
"practiceLocations": [
{
"address_1": "251 Llewellyn Ave",
"address_purpose": "LOCATION",
"city": "Campbell",
"state": "CA",
"postal_code": "950081940",
"country_code": "US",
"telephone_number": "408-379-3790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENDOZA",
"first_name": "JASMINE",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-20-40636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA",
"identifier": "1-20-40636",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.