Active NPI
Krystal Rose Mendoza, AMFT
- Marriage & Family Therapist
- Fresno, CA
National Provider Identifier
1841880994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 100327
- Practice address
- 2665 N Air Fresno Drive, Ste. 111
Fresno, CA 93727-1670 - Phone
- (559) 878-5090
- NPI assigned
- Jan 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 100327 | CA | Primary |
Addresses
Primary practice location
2665 N Air Fresno Drive, Ste. 111
Fresno, CA 93727-1670
Mailing address
1945 N Helm Ave Ste 101
Fresno, CA 93727-1670
Phone (559) 222-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106H00000X | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transitions Children'S Services | Past | Accepting new patients | |
| Transitions Children'S Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Case Management Agency
- Fresno, CA
- NPI 1245674324
-
- Foster Care Agency
- Fresno, CA
- NPI 1255715504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1841880994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1945 N HELM AVE STE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271670",
"telephone_number": "559-222-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2665 N AIR FRESNO DRIVE, STE. 111",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271670",
"telephone_number": "559-878-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "KRYSTAL",
"middle_name": "ROSE",
"name_prefix": "Miss",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-22",
"last_updated": "2021-04-06",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "100327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106H00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.