Individual provider Active NPI

Maribel Mendoza, BSW

  • Clinical Social Worker
  • Yakima, WA
National Provider Identifier
1720417256
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CG60420696 Issued in WA
Practice address
5301 Tieton Drive, Suite C
C/O Catholic Family & Child Service
Yakima, WA 98908-3478
Phone
(509) 965-7100
Fax
(509) 966-9750
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CG60420696 WA Primary

Addresses

Primary practice location

5301 Tieton Drive, Suite C
C/O Catholic Family & Child Service
Yakima, WA 98908-3478

Mailing address

5301 Tieton Drive, Suite C
C/O Catholic Family & Child Service
Yakima, WA 98908-3478
Phone (509) 965-7100

Other names 1

  • Maribel Vasquez Carmona Other name

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

LicenseStateTypeSpecialty
CG60420696WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1720417256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 TIETON DRIVE, SUITE C",
            "address_2": "C/O CATHOLIC FAMILY & CHILD SERVICE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083478",
            "telephone_number": "509-965-7100",
            "fax_number": "509-966-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 TIETON DRIVE, SUITE C",
            "address_2": "C/O CATHOLIC FAMILY & CHILD SERVICE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083478",
            "telephone_number": "509-965-7100",
            "fax_number": "509-966-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARIBEL",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "CG60420696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIBEL",
            "last_name": "VASQUEZ CARMONA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.