Marianne Buenaventura Mendoza, ASW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW83609 Issued in CA

Practice address

39159 Paseo Padre Pkwy Ste 121
Fremont, CA 94538-1600

Phone

(510) 952-1190

NPI assigned

May 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cordilleras

  • Mental Health Counselor
  • Redwood City, CA
  • NPI 1033699772
  NPD Authorized official

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

{
    "created_epoch": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1679148654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18606 GALTON LN",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945412280",
            "telephone_number": "510-331-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39159 PASEO PADRE PKWY STE 121",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381600",
            "telephone_number": "510-952-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARIANNE",
        "middle_name": "BUENAVENTURA",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-23",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW83609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033699772",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://app.kareo.com/login-ui/#/login",
            "affiliation": "N",
            "endpointDescription": "Kareo",
            "address_1": "39159 Paseo Padre Pkwy Ste 121",
            "city": "Fremont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945381600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Autumn Marie Mendez, RN
• Lindsay Mendez
• Nitalia Mendiola
• Erika Mendoza
• Hector Ethan Mendoza
• Melissa Mendoza
• Tanya Mendoza
• Yvette Mendoza
• Reema Menezes, MD
• Hongmei Meng, MD

• Clinical Social Worker in Fremont, CA
• Providers in Fremont, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.