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Individual

PETRA JEANNE MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4150 V ST STE 1200, SACRAMENTO, CA 95817-1460
(916) 734-5028
Mailing address
4150 V ST STE 1200, SACRAMENTO, CA 95817-1460
(916) 734-5028

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
844397
CA
163WC0200X
Critical Care Medicine Registered Nurse
683820
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
95001876
CA

Other

Enumeration date
07/09/2020
Last updated
11/07/2022
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