Celene Marie Mendoza, INTAKE SPECIALIST

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

350 E Gobbi St
Ukiah, CA 95482-5511

Phone

(707) 467-2010

Fax

(707) 467-2010

NPI assigned

Oct 16, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Anchor Health Management, Inc.

  • Psychiatry Physician
  • Fort Bragg, CA
  • NPI 1306681226
  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1710498811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954821449",
            "telephone_number": "707-472-0350",
            "fax_number": "707-472-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E GOBBI ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825511",
            "telephone_number": "707-467-2010",
            "fax_number": "707-467-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Cypress St",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "CA",
            "postal_code": "954375400",
            "country_code": "US",
            "telephone_number": "707-472-0350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "CELENE",
        "middle_name": "MARIE",
        "credential": "INTAKE SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mendocino Lake Audiology Inc.
• Mendocino Lake Hearing Care, Inc (Mendocino Lake Audiology)
• Mendocino Optical Co Inc
• Mendocino Physical Therapy
• Jorge Mendoza Reyes
• Jasmin Mendoza
• Olga Mendoza
• Ophelia N Mendoza, RDH
• Monica Menjivar
• Robert Floyd Merritt, PT

• Community Health Worker in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.