Individual provider Active NPI

Maria L Mendoza, LMFT

  • Marriage & Family Therapist
  • Visalia, CA
National Provider Identifier
1790011781
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
91080 Issued in CA
Practice address
130 N Conyer St
Visalia, CA 93291-5907
Phone
(559) 429-8414
NPI assigned
Oct 26, 2009
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X 91080 CA Primary

Addresses

Primary practice location

130 N Conyer St
Visalia, CA 93291-5907

Mailing address

130 N Conyer St
Visalia, CA 93291-5907
Phone (559) 429-8414

Other practice location 1

109 NW 2nd Ave
Visalia, CA 93291-3672
Phone (559) 627-1490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111004261 CA Practitioner - Marriage and Family Therapist 5698126852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaweah Delta Health Care DistrictGroup PAC ID 6608778790, 110 clinicians

Practice addresses (Care Compare)

301 W Noble Ave
Visalia, CA 93277-2633
Phone (559) 624-6875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District CurrentSince Jan 1, 2024 Accepting new patients
Kaweah Delta Health Care District Current Accepting new patients
Kaweah Delta Health Care District CurrentSince Jan 1, 2024 Accepting new patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince May 1, 2025 Accepting new patients

Locations

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

301 W Noble Ave
Visalia, CA 93277
Phone (559) 624-6875

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1790011781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N CONYER ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915907",
            "telephone_number": "559-429-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N CONYER ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915907",
            "telephone_number": "559-429-8414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 NW 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932913672",
            "country_code": "US",
            "telephone_number": "559-627-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARIA",
        "middle_name": "L",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "91080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.