Active NPI
Joel Mendoza
- Clinical Social Worker
- Santa Ana, CA
National Provider Identifier
1982077467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 102399
- Practice address
- 2100 N Broadway Ste 101
Santa Ana, CA 92706-2624 - Phone
- (714) 245-6881
- Fax
- (714) 245-6891
- NPI assigned
- Nov 5, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 102399 | CA | Primary |
Addresses
Primary practice location
2100 N Broadway Ste 101
Santa Ana, CA 92706-2624
Mailing address
2100 N Broadway Ste 101
Santa Ana, CA 92706-2624
Phone (714) 245-6881
Other practice location 1
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612
Other practice location 2
5715 S Broadway
Los Angeles, CA 90037-4131
Phone (323) 948-0444
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 |
|---|---|---|---|
| 102399 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1982077467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 N BROADWAY STE 101",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927062624",
"telephone_number": "714-245-6881",
"fax_number": "714-245-6891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N BROADWAY STE 101",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927062624",
"telephone_number": "714-245-6881",
"fax_number": "714-245-6891"
}
],
"practiceLocations": [
{
"address_1": "4760 Sepulveda Blvd",
"address_purpose": "LOCATION",
"city": "Culver City",
"state": "CA",
"postal_code": "902304820",
"country_code": "US",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5715 S Broadway",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900374131",
"country_code": "US",
"telephone_number": "323-948-0444",
"fax_number": "323-948-0443",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENDOZA",
"first_name": "JOEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-05",
"last_updated": "2021-07-28",
"certification_date": "2021-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "102399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.