Mariateresa Mendoza Self, CMT, LMT

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

APIM-912071 Issued in CA

Practice address

3000 Arden Way
Suite 1-a
Sacramento, CA 95825-2000

Phone

(916) 488-5560

NPI assigned

Oct 21, 2016

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 identifiers 1

Other names 1

• Terri Self Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1659822831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 HICKORY ST",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786707",
            "telephone_number": "916-412-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARDEN WAY",
            "address_2": "SUITE 1-A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252000",
            "telephone_number": "916-488-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "MARIATERESA",
        "middle_name": "MENDOZA",
        "name_prefix": "Mrs.",
        "credential": "CMT, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "APIM-912071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13848",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "SELF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Select Cal Physical Therapy PC
• Select Physical Therapy Holdings, Inc.
• Amanda Self, SUDRC 13199
• Diana Self
• Erica I Self, LPT
• Christopher James Seligman, NP
• Katarina Selinsky
• Paul Selinsky
• Scott Thomas Selinsky, MA, IMF
• Viktoriya Viktorivna Seliverstova V, DDS

• Student in an Organized Health Care Education/Training Program in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.