Active NPI
Dulce Yazmin Mendez
- Marriage & Family Therapist
- La Mesa, CA
National Provider Identifier
1801038369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 113617
- Practice address
- 4990 Williams Ave
La Mesa, CA 91942-7409 - Phone
- (619) 668-4200
- NPI assigned
- Mar 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | IM95663 | CA | |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 1497883268 | CA | |
| Marriage & Family Therapist | 106H00000X | 113617 | CA | Primary |
Addresses
Primary practice location
4990 Williams Ave
La Mesa, CA 91942-7409
Mailing address
4990 Williams Ave
La Mesa, CA 91942-7409
Phone (619) 688-4200
Other practice location 1
2300 Boswell Rd Ste 245
Chula Vista, CA 91914-3523
Phone (619) 549-0329 ext. 715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37AL | Medicaid | CA |
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 |
|---|---|---|---|
| IM95663 | CA | MD | Mental Health Counselor |
| 1497883268 | CA | MD | Substance Use Disorder Rehabilitation Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1801038369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4990 WILLIAMS AVE",
"city": "LA MESA",
"state": "CA",
"postal_code": "919427409",
"telephone_number": "619-688-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4990 WILLIAMS AVE",
"city": "LA MESA",
"state": "CA",
"postal_code": "919427409",
"telephone_number": "619-668-4200"
}
],
"practiceLocations": [
{
"address_1": "2300 Boswell Rd Ste 245",
"address_purpose": "LOCATION",
"city": "Chula Vista",
"state": "CA",
"postal_code": "919143523",
"country_code": "US",
"telephone_number": "619-549-0329 x715",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENDEZ",
"first_name": "DULCE",
"middle_name": "YAZMIN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-30",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "IM95663",
"primary": false
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "CA",
"license": "1497883268",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "113617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "37AL",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.