Active NPI
Ralph Mendoza, M0504111259
- Addiction (Substance Use Disorder) Counselor
- Los Angeles, CA
National Provider Identifier
1699142455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- M0504111259
- Practice address
- 2307 W 6TH St
Los Angeles, CA 90057-3119 - Phone
- (213) 351-2821
- Fax
- (213) 351-2852
- NPI assigned
- Aug 27, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | M0504111259 | CA | Primary |
Addresses
Primary practice location
2307 W 6TH St
Los Angeles, CA 90057-3119
Mailing address
2307 W 6TH St
Los Angeles, CA 90057-3119
Phone (213) 351-2821
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M0504111259 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1699142455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2307 W 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900573119",
"telephone_number": "213-351-2821",
"fax_number": "213-351-2852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2307 W 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900573119",
"telephone_number": "213-351-2821",
"fax_number": "213-351-2852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "RALPH",
"name_prefix": "Mr.",
"credential": "M0504111259",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-27",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "M0504111259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.