Keana Glen Mendoza, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

85110 Issued in CA

Practice address

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Phone

(310) 423-3277

NPI assigned

May 15, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1710736558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13281 COPPERWIND LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921294663",
            "telephone_number": "858-925-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "KEANA",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "85110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melrose Gardens la LLC
• Gabriella Meltz
• Men's Health Foundation 8280
• Daniella Shaina Menashe, MS, LCGC
• Brian Mendelson, M.D.
• Maria Concepcion De Jesus Mendoza, MD
• Matthew Mendoza
• Paul Gabriel Palmani Mendoza, NP
• Michael Asi Mensah, D.C.
• Lynn Elise Mercer, M.D.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.