Individual
ALBERT SOARES MENDONCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 W G ST, LOS BANOS, CA 93635-3657
(209) 710-6100
Mailing address
27425 GUN CLUB RD, GUSTINE, CA 95322-9709
(209) 678-5502
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW125151
CA
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/07/2023
Last updated
10/11/2024
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